Risk factors and clinical correlates of neoplastic transformation in gastric hyperplastic polyps in Chinese patients

• Published in: Scientific reports 2020-02, Vol.10 (1), p.2582, Article 2582
• Main Authors: Hu, Haiyi, Zhang, Qian, Chen, Guangyong, Pritchard, D. Mark, Zhang, Shutian
• Format: Article
• Language: English
• Subjects: 13; 13/1; 13/51; 692/4020/1503/1828/1500; 692/4020/1503/1828/1829; 692/4020/198; Adenomatous Polyps - blood; Adenomatous Polyps - genetics; Adenomatous Polyps - pathology; Adenomatous Polyps - surgery; Adult; Aged; Antibodies, Neoplasm - blood; Cell Transformation, Neoplastic - genetics; Endoscopy - methods; Female; Gastritis; Gender; Helicobacter Infections - blood; Helicobacter Infections - genetics; Helicobacter Infections - pathology; Helicobacter Infections - surgery; Helicobacter pylori - pathogenicity; Humanities and Social Sciences; Humans; Male; Middle Aged; multidisciplinary; Parietal Cells, Gastric - metabolism; Parietal Cells, Gastric - pathology; Polyps; Risk Factors; Science; Science (multidisciplinary); Serology; Stomach Neoplasms - blood; Stomach Neoplasms - genetics; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-58900-z

Gastric hyperplastic polyps (GHPs) have a potential risk of neoplastic transformation, but the responsible mechanisms have not yet been established. We conducted a study involving 55 patients (33 female) who had undergone endoscopic or surgical resection of GHPs. We compared 16 patients who had GHPs showing neoplastic transformation with 39 patients who had non-neoplastic GHPs. We analyzed differences in serology, gastroscopic manifestations and pathology between the two groups in order to establish risk factors that may be associated with neoplastic transformation. The mean age of the cohort was 61.73 ± 9.024 years. The prevalence of positive serum gastric parietal cell antibody (PCA) was 61.8%. 30 of the GHPs with neoplastic formation had a “strawberry-like” appearance with erosions of polyps ( P  = 0.000). A history of anaemia was a risk factor for GHPs which demonstrated neoplastic transformation (odds ratio [OR], 3.729; 95% confidence interval [CI], 1.099–12.649; P  = 0.035). Although the differences were not significant, our data showed higher prevalences of positive serum PCA ( P  = 0.057), hypergastrinemia ( P  = 0.062) and female gender ( P  = 0.146) in the GHP patients who had neoplastic transformation. Multiple polyps in the corpus ( P  = 0.024) occurred more frequently in serum P CA positive patients. Hypergastrinemia occurred more frequently in Helicobacter pylori negative patients and of these 20/22 patients had a positive PCA ( P  = 0.007). GHPs are associated with autoimmune metaplastic atrophic gastritis (AMAG). AMAG is probably one of the risk factors for GHPs to undergo neoplastic transformation.