Endoscopic & Histopathological Pattern of Gastric Polyps and their Relationship with Helicobacter pylori Infection

Abstract

Introduction: Gastric polyps are abnormal luminal growths projecting above the plane of the mucosal surface of the stomach. These may be malignant or non-malignant. Hyperplastic polyps are more frequent than other gastric polyps, where H. pylori infections are commonly seen. Most hyperplastic polyps disappear or regress after H. pylori eradication. In Bangladesh, the prevalence of H. pylori in the adult is >92%. The test and treat strategy is not well practised in our country. So, estimation of H. Pylori infection related to gastric polyp is necessary. Aim of the Study: The study aims to investigate the endoscopic and histopathological pattern of gastric polyps with Helicobacter Pylori infection. Methods: This cross-sectional study was carried out in the department of Gastroenterology, BSMMU. In total 75 patients, 24 male and 51 female were included in this study. Information about the clinical profile, endoscopic findings, rapid urease test and histopathological findings were collected. Data were collected using a pre-designed data collection sheet. The collected data were analyzed by computer with the help of SPSS version 23. Statistical analysis was done by using an appropriate statistical tool like the Chi-square test, Student’s t-test, and regression test. Statistical significance will be defined as p<0.05. Result: Among the 75 patients with gastric polyps, the mean age of presentation was 51.08±13.85 years. Regarding clinical presentation, 28(32%) patients had abdominal pain followed by 21(28%) with nausea, 19(25.3%) with weight loss, 12(16%) with vomiting, 10(13.3%) with anaemia, 6(8%) with hematemesis and 4(5.3%) with Malena. The most common site of gastric polyps was the antrum 42(56%), 21(28%) in the body, 7(9.3%) in the cardia and 5(6.7%) in the fundus. The majority of patients had polyps sized between 5-10 mm, 43(60%) patients. The association between the number, size, and size of the gastric polyps were not statistically significant between H. Pylori positive and H. Pylori negative groups. Based on histopathological type, hyperplastic polyp 66(88%), fundic gland polyp 7(9.33%) and adenomatous polyp 2(2.67%) were observed. Regarding the relationship with H. Pylori infection, hyperplastic was significantly associated with the H. Pylori positive group (p<0.004) whereas fundic gland polyp was negatively associated (p<0.001) with H. Pylori infection in this study. Conclusion: In this study, the majority of polyps detected by endoscopy were solitary, size between 5-10 mm. Most of them were located in the antrum. Histopathologically, hyperplastic polyps were the most common and related to H. Pylori infection