Clinical features of different pathological types of gastric polyps and risk factors of gastric polyps concurrent with colon polyps
Objective To analyze the clinicopathological features of patients with different pathological types of gastric polyps,and to explore the risk factors of gastric polyps concurrent with colon polyps.Methods A retrospective study was conducted in 3 049 patients with gastric polyps detected by gastroscopy in Jiading District Central Hospital of Shanghai from January 2017 to December 2020.According to pathological types,the patients were divided into 4 groups:inflammatory polyp group,hyperplastic polyp group,fundus glandular polyp group,and adenomatous polyp group.General information and endoscopic report data(the number,location,and size of gastric polyps)were collected and compared between patients with different pathological types.Atrophic gastritis,intestinal metaplasia,and Helicobacter pylori(H.pylori)infection were recorded.Colonoscopy results were collected during the same period.The risk factors of gastric polyp concurrent with colon polyp were investigated by univariate and multivariate logistic regression analyses.Results The detection rates of endoscopic gastric polyps in 2017,2018,2019 and 2020 were 4.5％,5.1％,7.0％and 7.5％,respectively,which showed an increasing trend year by year.There was a statistically significant difference in the detection rate of gastric polyps over the past 4 years(x2=134.270,P＜0.001).The detection rate of gastric polyps in 2020 was significantly higher than that in 2017(x2=89.883,P＜0.05).There were significant differences in the proportions of gastric fundus glandular polyps and inflammatory polyps in the 4 years(x2=12.708,13.898,both P＜0.05).Compared with those in 2017,the proportion of fundus glandular polyps in 2020 was significantly increased(x2=12.644,P＜0.05),and the proportion of inflammatory polyps in 2020 was significantly decreased(x2=13.811,P＜0.05).The patients with adenomatous polyps were older than the patients with the other three types of polyps(F=11.98,P＜0.001).There was significant difference in the proportions of patients aged ≥65 years old and＜65 years old among groups(x2=32.90,P＜0.05).There was significant difference in the proportions of patients with or without clinical symptoms among groups(x2=103.00,P＜0.05).There were significant differences in the number,location and size of gastric polyps,infection rate of H.pylori,gastric mucosa atrophy and intestinal metaplasia among groups(all P＜0.001).Single polyp was more common than multiple polyps in these patients(74.6％[2 274/3 049]vs 25.4％[775/3 049]).The incidence of multiple polyps in the inflammatory polyp group and hyperplastic polyp group was significantly lower than that in the fundus glandular polyp group(x2=58.416,17.624,both P＜0.001).The proportions of patients with gastric polyps＜0.5 cm in inflammatory polyp group and fundus glandular polyp group was significantly higher than that in the hyperplastic polyp group(x2=80.850,53.801,both P＜0.05).The infection rate of H.pylori in the fundus glandular polyp group was significantly lower than those in the inflammatory polyp group and hyperplastic polyp group(x2=42.714,6.704,P＜0.001 or 0.05).The incidence of gastric mucosa atrophy in the hyperplastic polyp group was significantly higher than those in the inflammatory polyp group and fundus glandular polyp group(x2=20.879,16.436,both P＜0.001).The incidence of intestinal metaplasia in the inflammatory polyp group was significantly higher than those in the hyperplastic polyp group and fundus glandular polyp group(x2=12.897,81.467,both P＜0.001).A total of 383 patients with gastric polyps underwent colonoscopy during the same period,and colon polyps were found in 129(33.7％)patients of them.The patients aged ≥65 years old had higher detection rate of colon polyps than the patients aged＜65 years old(P＜0.05).The patients with clinical symptoms had higher detection rate of colon polyps than asymptomatic patients(P＜0.05).Univariate logistic regression analysis showed that age ≥65 years and adenomatous polyp were the risk factors for gastric polyp concurrent with colon polyp.Moreover,multivariate analysis showed that age(OR=1.634,95％Cl:1.042-2.563,P=0.032)and adenomatous polyps(OR=3.743,95％Cl:1.295-10.819,P=0.015)were independent risk factors for gastric polyps concurrent with colorectal polyps.Conclusion The patient's age,the number,location and size of gastric polyps,H.pylori infection,gastric mucosa atrophy and intestinal metaplasia vary in patients with different pathological types of gastric polyps.It is suggested that elderly patients with adenomatous polyps should be screened by colonoscopy for colorectal polyps.
万方数据
维普
