Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Surg Endosc. 2023 Oct;37(10):7563-7572. doi: 10.1007/s00464-023-10194-8. Epub 2023 Jul 12.
The likelihood of recurrence of gastric hyperplastic polyps (GHPs) following endoscopic resection and the need for long-term follow-up remain unknown. We, therefore, aimed to investigate the factors associated with the recurrence and cumulative incidence of GHPs over a 10-year period.
Between May 1995 and December 2020, 1,018 GHPs > 1 cm were endoscopically resected from 869 patients. Medical records of these patients were retrospectively reviewed and their clinical features and outcomes were assessed. Groups of GHPs with recurrence and those without recurrence group were compared, and univariate and multivariable analyses were performed to identify the potential risk factors for GHP recurrence.
A total of 104 (12.0%) patients who underwent endoscopic removal of GHPs experienced recurrence. Compared to patients without recurrent GHPs, those with recurrent GHPs showed considerably larger median polyp size (28 mm vs. 14 mm, P < 0.001), a higher proportion of multiple polyps (41.3% vs. 29.3%, P = 0.020), polyps with lobulation (63.5% vs. 40.3%, P = 0.001), and exudate (63.5% vs. 46.8%, P = 0.001). Compared to the local recurrence (n = 52) group, the metachronous recurrence (n = 52) group had larger median polyp size (20 mm vs. 16 mm, P = 0.006) as well as higher rates of polyp lobulation (86.5% vs. 40.4%, P < 0.001) and exudate (82.7% vs. 44.4%, P = 0.001). After primary GHP excision, the cumulative incidence of recurrence was 7.2%, 12.7%, and 19.6% at 2 years, 5 years, and 10 years, respectively.
The incidence of GHP recurrence following endoscopic excision increased as the follow-up period increased, especially in patients whose GHPs were large-sized, multiple, or characterized by surface exudates/lobulations.
胃增生性息肉（GHPs）内镜切除后复发的可能性以及是否需要长期随访尚不清楚。因此，我们旨在研究 10 年内与 GHPs 复发和累积发生率相关的因素。
1995 年 5 月至 2020 年 12 月，869 例患者共内镜切除>1cm 的 GHPs1018 个。回顾性分析这些患者的病历资料，评估其临床特征和结局。比较有复发和无复发的 GHPs 组，并进行单变量和多变量分析，以确定 GHPs 复发的潜在危险因素。
104 例（12.0%）接受 GHPs 内镜切除的患者出现复发。与无复发性 GHPs 患者相比，复发性 GHPs 的息肉中位大小明显较大（28mm 比 14mm，P<0.001），多发性息肉比例较高（41.3%比 29.3%，P=0.020），有分叶的息肉（63.5%比 40.3%，P=0.001）和渗出物（63.5%比 46.8%，P=0.001）。与局部复发（n=52）组相比，异时性复发（n=52）组的息肉中位大小较大（20mm 比 16mm，P=0.006），分叶和渗出物的比例也较高（86.5%比 40.4%，P<0.001；82.7%比 44.4%，P=0.001）。初次 GHPs 切除后，复发的累积发生率分别为 2 年时 7.2%、5 年时 12.7%和 10 年时 19.6%。
随着随访时间的延长，内镜切除后 GHPs 的复发率增加，尤其是在 GHPs 较大、多发或表面有渗出物/分叶的患者中。
