Liao XH, Sun YM, Chen HB. New classification of gastric polyps: An in-depth analysis and critical evaluation. World J Gastroenterol 2025; 31(7): 101467 [DOI: 10.3748/wjg.v31.i7.101467]
Corresponding Author of This Article
Hong-Bin Chen, PhD, Chief Physician, Department of Gastroenterology I, Sanming First Hospital, Fujian Medical University, No. 29 Liedong Street, Sanyuan District, Sanming 365000, Fujian Province, China. smchb2008@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
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. Feb 21, 2025; 31(7): 101467 Published online Feb 21, 2025. doi: 10.3748/wjg.v31.i7.101467
New classification of gastric polyps: An in-depth analysis and critical evaluation
Xiao-Hui Liao, Ying-Ming Sun, Hong-Bin Chen
Xiao-Hui Liao, Department of Gastroenterology, The First Hospital of Sanming Affiliated to Fujian Medical University, Fujian Medical University, Sanming 365000, Fujian Province, China
Ying-Ming Sun, Department of Medical and Radiation Oncology, Sanming First Hospital, Fujian Medical University, Sanming 365000, Fujian Province, China
Hong-Bin Chen, Department of Gastroenterology I, Sanming First Hospital, Fujian Medical University, Sanming 365000, Fujian Province, China
Co-corresponding authors: Ying-Ming Sun and Hong-Bin Chen.
Author contributions: Liao XH contributed to the discussion and design of the manuscript; Sun YM and Chen HB designed the overall concept and outlined the manuscript; Liao XH, Sun YM, and Chen HB contributed equally to this paper, and they participated in the writing, editing, and linguistic embellishment of the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
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: Hong-Bin Chen, PhD, Chief Physician, Department of Gastroenterology I, Sanming First Hospital, Fujian Medical University, No. 29 Liedong Street, Sanyuan District, Sanming 365000, Fujian Province, China. smchb2008@qq.com
Received: September 15, 2024 Revised: December 2, 2024 Accepted: December 17, 2024 Published online: February 21, 2025 Processing time: 126 Days and 17.7 Hours
Abstract
With the widespread use of upper gastrointestinal endoscopy, more and more gastric polyps (GPs) are being detected. Traditional management strategies often rely on histopathologic examination, which can be time-consuming and may not guide immediate clinical decisions. This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation, categorizing them as "good", "bad", and "ugly". A review of the literature and clinical case analysis were conducted to explore the clinical implications, management strategies, and the system's application in endoscopic practice. Good polyps, mainly including fundic gland polyps and inflammatory fibrous polyps, have a low risk of malignancy and typically require minimal or no intervention. Bad polyps, mainly including hyperplastic polyps and adenomas, pose an intermediate risk of malignancy, necessitating closer monitoring or removal. Ugly polyps, mainly including type 3 neuroendocrine tumors and early gastric cancer, indicate a high potential for malignancy and require urgent and comprehensive treatment. The new classification system provides a simplified and practical framework for diagnosing and managing GPs, improving diagnostic accuracy, guiding individualized treatment, and promoting advancements in endoscopic techniques. Despite some challenges, such as the risk of misclassification due to similar endoscopic appearances, this system is essential for the standardized management of GPs. It also lays the foundation for future research into biomarkers and the development of personalized medicine.
Core Tip: When performing endoscopy of the upper gastrointestinal tract, physicians often find gastric polyps (GPs), which are, for the most part, harmless. However, physicians need to have an in-depth knowledge of diagnostic tools, therapeutic strategies, and screening procedures, especially for those polyps with a potential risk of becoming cancerous. This paper introduces a new classification system for GPs based on the possible risk of cancerous transformation of the polyp, with three different classifications, namely, “good”, “bad”, and “ugly”, corresponding to different interventions and management by the clinician and influencing the different prognoses of the patients.
