The Discordance Between Endoscopic Forceps Biopsy and Endoscopic Polypectomy Specimen of Gastric Polyps

Abstract

Background: Gastric polyp is a descriptive term referring to mucosal prominence that protrudes beyond the flat lining of the stomach. Almost 90% of gastric polyps are hyperplastic polyps. Adenomatous polyps may contain focal carcinomatous changes or undergo carcinomatous changes. It is known that there is some degree of discordance between the results of endoscopic forceps biopsy and pathology of resected specimens. The aim of this study was to investigate the discordance between endoscopic forceps biopsy and endoscopic polypectomy specimen of gastric polyps and to review the pathology of polypectomy specimen. Methods: We reviewed endoscopic photographs, medical records, and pathology results of the patients who underwent endoscopic polypectomy from April of 1996 to February of 2003. Results: 86 patients and 101 cases of gastric polyps were reviewed. Male-to-female ratio was 1:1.9. Mean age was 58.6±12.7 years. 87.2% of the patients had 1 polyp, 8.1% had 2, and 4.7% had 3. Gastric polyps occurred in the antrum most frequently (59.4%). Postpolypectomy pathology results were as follows: tubular adenoma 38.6%, hyperplastic polyp 27.7%, inflammatory polyp 9.9%, hamartoma 3%, fundic gland polyp 3%, tubulovillous adenoma 2%, adenocarcinoma 2%, dysplasia 1%, mucosal pseudolipomatosis 1%. Pathology was not checked in 6.9%; 4% did not undergo polypectomy. Concordance rate between endoscopic biopsy and pathology of resected specimens was 64.1%. There was no relationship between the size of the polyp and concordance rate. Conclusion: The concordance rate between endoscopic biopsy and pathology of resected specimens was 64.1%. There was no relationship between the size of the polyp and concordance rate. Therefore, additional approaches to review the histology of an entire polyp should be performed, especially when an adenoma is suspected.