Endoscopic and pathological features of neoplastic transformation of gastric hyperplastic polyps: Retrospective study of 4010 cases

Table 1 Features of gastric hyperplastic polyps in different groups and univariate logistic regression analysis of risk factors for neoplastic transformation

	GHPs without IN (n = 3874)	GHPs with IN (n = 136)	χ2 test		Univariate analysis
			χ2 value	P value	P value	OR (95%CI)
Age (mean ± SD), years	57.86 ± 0.22	64.76 ± 1.04	37.178	< 0.001	< 0.001	1.761 (1.459-2.126)
≤ 45 years, n (%)	699 (18)	9 (6)
45-65 years, n (%)	1988 (51)	54 (40)
> 65 years, n (%)	1187 (31)	73 (54)
Sex, n (%)			9.057	0.011	0.003	1.672 (1.188-2.356)
Male	1423 (37)	67 (49)
Female	2451 (63)	69 (51)
H. pylori infection, n (%)	782 (20)	22 (16)	1.865	0.172	0.174	0.721 (0.450-1.155)
Multiple polyps, n (%)	1122 (29.4)	62 (46)	23.162	< 0.001	< 0.001	2.275 (1.614-3.207)
Polyp size (mean ± SD), cm	0.66 ± 0.01		203.055	< 0.001	< 0.001	3.634 (2.948-4.478)
≤ 1 cm	3406 (88)	66 (48)
1 cm-2 cm	374 (10)	53 (39)
> 2 cm	94 (2)	17 (13)
Endoscopic color, n (%)			18.626	< 0.001	0.03	0.671 (0.472-0.972)
Normal	2113 (55)	53 (40)
Red	1488 (40)	82 (60)
White	275 (5)	1 (0)
Mucosal erosion, n (%)	289 (8)	30 (22)	38.701	< 0.001	< 0.001	3.538 (2.318-5.402)
Polyp lobulation, n (%)	185 (5)	25 (18)	49.109	< 0.001	< 0.001	4.491 (2.840-7.102)
Mucosal roughness, n (%)	864 (22)	69 (51)	59.494	< 0.001	< 0.001	3.588 (2.542-5.064)
Endoscopic classification, n (%)			169.676	< 0.001	< 0.001	2.604 (2.210-3.067)
I	2480 (64)	35 (26)
II	1007 (26)	42 (31)
III	233 (6)	27 (20)
IV	155 (4)	32 (23)
Location, n (%)			23.926	< 0.001	< 0.001	1.750 (1.384-2.212)
Upper third	1457 (38)	31 (23)
Middle third	1715 (44)	60 (44)
Lower third	702 (18)	45 (33)
Background gastric mucosa, n (%)			81.877	< 0.001	< 0.001	1.699 (1.472-1.960)
Autoimmune gastritis	364 (9.4)	29 (21)
Chronic superficial gastritis	2466 (64)	42 (31)
Chronic atrophic gastritis	712 (18)	31 (23)
Gastritis with IN	332 (9)	34 (25)

OR: Odds ratio; CI: Confidence interval; GHPs: Gastric hyperplastic polyps; IN: Intraepithelial neoplasia; H. pylori: Helicobacter pylori.

Table 2 Multivariate logistic regression analysis of risk factors for neoplastic transformation of gastric hyperplastic polyps

Risk factors	P value	OR	95%CI
Age
≤ 65 years		1
> 65 year	0.003	1.789	1.227-2.609
Sex
Female		1
Male	0.006	1.680	1.158-2.438
Number
Single	1
Multiple (n ≥ 2)	0.003	1.851	1.230-2.784
Polyp size
≤ 1 cm		1
1 cm-2 cm	< 0.001	3.565	2.177-5.838
> 2 cm	< 0.001	3.756	1.909-7.392
Endoscopic color-red	0.701	0.916	0.619-1.356
Mucosal erosion	0.271	0.75	0.454-1.255
Polyp lobulation	0.264	0.73	0.432-1.263
Mucosal roughness	0.128	1.38	0.912-2.093
Shape
Non-pedunculated		1
Pedunculated or semi-pedunculated	< 0.001	2.722	1.689-4.388
Location, n (%)
Upper third		1
Middle third	0.066	0.609	0.368-1.011
Lower third	0.055	1.624	0.968-2.724
Background gastric mucosa
Chronic superficial gastritis		1
Chronic atrophic gastritis	0.014	1.876	1.134-3.103
Gastritis with intraepithelial neoplasia	< 0.001	5.299	3.173-8.849
Autoimmune gastritis	< 0.001	2.672	1.559-4.579

OR: Odds ratio; CI: Confidence interval.

Table 3 Analysis of gastric hyperplastic polyps with low-grade and high-grade intraepithelial neoplasia

	GHPs with low-grade IN (n = 119)	GHPs with high-grade IN (n = 17)	χ2 test		Univariate analysis
			χ2 value	P value	P value	OR (95%CI)
Age (mean ± SD), years	64.49 ± 1.13	67.93 ± 2.55		0.6621	0.404	1.461 (0.600-3.555)
≤ 45 years, n (%)	8 (7)	1 (6)
45-65 years, n (%)	49 (41)	5 (30)
> 65 years, n (%)	62 (52)	11 (65)
Sex (male), n (%)	57 (48)	10 (59)	0.710	0.399	0.402	1.544 (0.554-4.355)
H. pylori infection, n (%)	20 (17)	2 (12)		0.6541	0.655	0.702 (0.148-3.322)
Multiple polyps, n (%)	51 (43)	11 (65)	2.035	0.154	0.542	2.133 (0.741-6.145)
Polyp size (mean ± SD), cm	1.25 ± 0.07	2.2 ± 0.32	16.624	0.024	0.017
≤ 1 cm	63 (52)	3 (18)			-	1
1 cm-2 cm	46 (39)	7 (41)			0.034	6.956 (1.159-41.729)
> 2 cm	10 (8)	7 (41)			0.490	1.766 (0.352-8.865)
Endoscopic color, n (%)			3.382	0.184	0.232	2.455 (0.826-7.294)
Normal	50 (42)	4 (24)
Red	69 (58)	13 (76)
Mucosal erosion, n (%)	23 (20)	7 (41)	4.403	0.051	0.224	2.891 (0.994-8.411)
Polyp lobulation, n (%)	19 (16)	6 (35)	3.704	0.054	0.086	2.781 (0.947-8.703)
Mucosal roughness, n (%)	58 (49)	11 (65)	1.517	0.218	0.237	1.928 (0.670-5.552)
Endoscopic classification, n (%)				0.0201	0.331
I	35 (29)	0 (0)
II	40 (34)	2 (12)
III	19 (16)	8 (47)
IV	25 (21)	7 (41)
Shape, n (%)			8.600	0.003
Non-pedunculated	75 (63)	2 (12)			-	1
Pedunculated or semi-pedunculated	44 (37)	15 (82)			0.010	7.375 (1.615-33.671)
Location, n (%)			4.451	0.103	0.302	0.632 (0.316-1.263)
Upper third	27 (23)	4 (24)
Middle third	49 (41)	11 (65)
Lower third	43 (36)	2 (12)
Background gastric mucosa, n (%)				0.5531	0.644	1.788 (0.362-8.388)
Autoimmune gastritis	24 (20)	5 (29)
Chronic superficial gastritis	39 (33)	3 (18)
Chronic atrophic gastritis	26 (22)	5 (29)
Gastritis with IN	30 (25)	4 (24)

¹P value means using Fisher’s exact test.

OR: Odds ratio; CI: Confidence interval; GHPs: Gastric hyperplastic polyps; IN: Intraepithelial neoplasia; H. pylori: Helicobacter pylori.