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gastric hyperplastic polyp with focal cancer

Gastroenterology Report 2016年第2期4卷 158-161,I0003页

作者： Adam Roman Markowski Katarzyna Guzinska-Ustymowicz Department of Internal Medicine and Gastroenterology Polish Red Cross Memorial Municipal HospitalBialystokPoland Endoscopy Unit and Outpatient Department Hospital of the Ministry of InteriorBialystokPoland Department of General Pathomorphology Medical University of BialystokBialystokPoland

This paper reports a rare case of early adenocarcinoma within the gastric hyperplastic polyp,that was completely resected during an endoscopic procedure,and discusses current recommendations in such *** resection of polyps with focal dysplasia or cancer is commonly indicated,as long as the procedure can be performed *** complete excision of a polyp with atypical focal lesion,endoscopic surveillance is *** frequency of surveillance endoscopy should depend on the precise histopathological diagnosis and possibility of confirming the completeness of the endoscopic *** the completeness of the procedure is confirmed both macro-and microscopically,gastric resection does not have to be performed.A follow-up esophago-gastroduodenoscopy should be performed at 1 year and then at 3 years.

关键词： gastric hyperplastic polyp gastric cancer surveillance

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Pathophysiological and clinical aspects of gastric hyperplastic polyps

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World Journal of Gastroenterology 2016年第40期22卷 8883-8891页

作者： Adam Roman Markowski Agnieszka Markowska Katarzyna Guzinska-Ustymowicz Department of Internal Medicine and Gastroenterology Polish Red Cross Memorial Municipal Hospital Department of Organic Chemistry Medical University of Bialystok Department of General Pathomorphology Medical University of Bialystok

gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori(H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.

关键词： gastric hyperplastic polyp Pathophysiology gastric cancer Surveillance

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