Endoscopic differential diagnosis between foveolar-type gastric adenoma and gastric hyperplastic polyps in Helicobacter pylori-naïve patients

Background Foveolar-type gastric adenoma (FGA) occurs in Helicobacter pylori ( Hp )-naïve individuals and morphologically mimics Hp -naïve gastric hyperplastic polyp (HpN-GHP). FGA is often difficult to distinguish from HpN-GHP even by biopsy, due to its low-grade histologic atypia. We conducted a r...

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Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2023-11, Vol.26 (6), p.1002-1011
Main Authors: Shibagaki, Kotaro, Ishimura, Norihisa, Kotani, Satoshi, Fukuyama, Chika, Takahashi, Yusuke, Kishimoto, Kenichi, Yazaki, Tomotaka, Kataoka, Masatoshi, Omachi, Taisuke, Kinoshita, Yasuhito, Hasegawa, Nobuaki, Oka, Akihiko, Mishima, Yoshiyuki, Mishiro, Tsuyoshi, Oshima, Naoki, Kawashima, Kousaku, Nagase, Mamiko, Araki, Asuka, Kadota, Kyuichi, Ishihara, Shunji
Format: Article
Language:English
Subjects:
Abdominal Surgery
Accuracy
Adenoma
Adenomatous Polyps - diagnosis
Biopsy
Cancer Research
Capillaries
Diagnosis, Differential
Differential diagnosis
Endoscopy
Gastric cancer
Gastroenterology
Gastroscopy - methods
Helicobacter pylori
Histology
Humans
Hyperplasia
Medicine
Medicine & Public Health
Oncology
Original Article
Polyps
Retrospective Studies
Stomach Neoplasms - diagnosis
Stomach Neoplasms - pathology
Surgical Oncology
Tumors
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Summary:Background Foveolar-type gastric adenoma (FGA) occurs in Helicobacter pylori ( Hp )-naïve individuals and morphologically mimics Hp -naïve gastric hyperplastic polyp (HpN-GHP). FGA is often difficult to distinguish from HpN-GHP even by biopsy, due to its low-grade histologic atypia. We conducted a retrospective study to create an endoscopic diagnostic index. Methods We analyzed 51 FGAs in 41 patients and 36 HpN-GHPs in 24 patients. All lesions were photographed by white-light endoscopy (WLE) and narrow-band imaging with magnification endoscopy (NBIME). Three experts and three non-experts reviewed the WLE and WLE+NBIME images to assess six items for lesion diagnosis. We analyzed correlations between the diagnostic items and histologic features and compared the diagnostic accuracy between modalities. We created a composite diagnostic index and calculated its accuracy and consistency. Results FGAs more frequently showed the following features vs. HpN-GHPs: bright-red color (94.1% vs. 44.4%), peripheral hyperplasia (58.8% vs. 8.3%), papillary/gyrus-like microstructure (96.1% vs. 33.3%), visible capillaries (70.6% vs. 38.9%), and demarcation line (98.0% vs. 41.7%) ( P  
ISSN:1436-3291
1436-3305
1436-3305
DOI:10.1007/s10120-023-01420-2