Costa D, Ramai D, Tringali A. Novel classification of gastric polyps: The good, the bad and the ugly. World J Gastroenterol 2024; 30(31): 3640-3653 [DOI: 10.3748/wjg.v30.i31.3640]
Corresponding Author of This Article
Alberto Tringali, MD, Chief Doctor, Honorary Research Fellow, Lecturer, Department of Digestive Endoscopy and Gastroenterology, AULSS2, Conegliano Hospital, Via Brigata Bisagno, Conegliano 31015, Italy. albtri10@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 21, 2024; 30(31): 3640-3653 Published online Aug 21, 2024. doi: 10.3748/wjg.v30.i31.3640
Novel classification of gastric polyps: The good, the bad and the ugly
Deborah Costa, Daryl Ramai, Alberto Tringali
Deborah Costa, Alberto Tringali, Department of Digestive Endoscopy and Gastroenterology, AULSS2, Conegliano Hospital, Conegliano 31015, Italy
Daryl Ramai, Department of Gastroenterology, Division of Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, United States
Author contributions: Costa D and Tringali A conceived the idea; Costa D, Ramai D, and Tringali A wrote and edited the manuscript; all authors have read, reviewed and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alberto Tringali, MD, Chief Doctor, Honorary Research Fellow, Lecturer, Department of Digestive Endoscopy and Gastroenterology, AULSS2, Conegliano Hospital, Via Brigata Bisagno, Conegliano 31015, Italy. albtri10@gmail.com
Received: May 22, 2024 Revised: July 19, 2024 Accepted: August 2, 2024 Published online: August 21, 2024 Processing time: 82 Days and 9.4 Hours
Abstract
Gastric polyps (GPs) are increasingly common. On upper endoscopy, they should be examined with white light and occasionally chromoendoscopy, and their morphology classified according to the Paris classification. Most GPs have a typical endoscopic appearance and can be associated with diseases like Helicobacter pylori infection. Histological examination is necessary for an accurate diagnosis. While most polyps are non-neoplastic and do not require treatment, some carry a risk of malignancy or are already malignant. Therefore, understanding the diagnosis, classification, and management of GPs is crucial for patient prognostication. Our new classification categorizes GPs into "good", "bad", and "ugly" based on their likelihood of becoming malignant. We aim to provide descriptions of the endoscopic appearance, pathology, treatment, and follow-up for different GPs, as well as clinical management flowcharts.
Core Tip: During upper gastrointestinal endoscopy, gastric polyps are frequently encountered, however, most are benign. Despite this, it is crucial that endoscopist have a thorough understanding of diagnostic approaches, management strategies, and screening protocols, particularly for polyps with neoplastic potential. We have developed a new classification system for gastrointestinal polyps based on their likelihood of becoming malignant, categorizing them into "good", "bad", and "ugly" groups. This classification aims to assist clinicians in managing and treating polyps effectively.