Clinical, endoscopic features and histopathology classification of gastrointestinal polyps

Abstract

Background: Gastrointestinal polyps are common, proliferative or neoplastic mucosal lesions protruding into the lumen of the digestive tract. Gastrointestinal polyps are considered to be precursors to cancer development. Therefore, the cancer potential can be reduced to a great extent by early detection and removal of polyps. Clinical symptoms of the disease are often poor and unclear so early detection and diagnosis are definitely based on endoscopy and especially histopathology to classify and evaluate benign or malignant potential of polyps. Objectives: 1. To describe some clinical and endoscopic features of gastrointestinal polyps. 2. To diagnose and classify histopathological types of gastrointestinal polyps, evaluate the correlation of some endoscopic features and histopathology. Materials and Methods: Cross-sectional research on 77 patients diagnosed by Endoscopy and histopathology at the Hospital of Hue University of Medicine and Pharmacy from 02.2020 to 01.2022. Results: Gastrointestinal polyps were common in patients ≥ 60 years (49.4%), the ratio of male/female was 1.4. Common reasons for hospital admission: abdominal pain (33.8%), hematochezia (31.2%). Common symptoms: abdominal pain 62.5%, hematochezia 35.1%. The majority of polyps were located in the colorectal at a rate of 89.6%. Number of polyps per patient: Single polyp (66.2%), multiple polyps (33.8%), no polyposis case. Polyps usually have the characteristics: peduncle (66.2%), clear boundary (80.5%), smooth surface (71.4%). Size of polyps: < 1 cm (74%), > 2 cm were very rare, accounting for 2.6%. Histopathological results showed that adenoma and hyperplasia polyps accounted for the highest proportion, respectively 46.8% and 40.3%. Level of dysplasia: no dysplasia (48%), low grade dysplasia (37.7%) and high grade dysplasia (14.3%). Adenocarcinoma polyps accounted for 5.2% (4 patients), of which 2 patients had carcinoma in situ and 2 patients with invasive adenocarcinoma. There was no statistically significant difference between the endoscopic features and the histopathological results. Conclusion: Endoscopy is a common and effective means to detect gastrointestinal polyps. However, the nature of these polyps has yet to be confirmed, especially the high risk ones of malignancy. For this reason, a biopsy or excision of the polyp is necessary for histopathology Key words: Gastrointestinal polyps, endoscopy, histopathology.