Gastric hyperplastic polyps: a narrative review

Abstract

Background and Objective: Despite the fact gastric hyperplastic polyps (GHP) are found in less than 10% of endoscopies, current studies suggest possible malignant potential and as such clinicians should be aware of GHP characteristics when they encounter those lesions. This review aims to provide the most current information regarding GHP including epidemiology data, possible etiologies and associations, their presentation features, their malignancy potential, and their histologic characteristics. This review’s other objective is also to provide useful information for their endoscopic appearance and current recommendations for their endoscopic management. Methods: For the current review, extensive literature research was conducted in multiple databases until December 2021. Only studies published in English were considered. Three independent reviewers assessed and analyzed literature. Key Contents and Findings: Multiple risk factors have been linked to GHP pathogenesis and development, including Helicobacter pylori (H. pylori) infection, atrophic and autoimmune gastritis. The symptoms associated with GHP may include dyspepsia and gastroesophageal reflux but most often are subtle. Even though GHP are traditionally considered benign lesions, growing evidence suggests malignant potential with some studies describing a malignant transformation risk higher than 8%. Older age, increased size and pedunculated shape are some of the risk factors associated with malignant transformation. Especially GHP larger than 10 mm have greater malignancy risk and should be excised. Conclusions: GHP are not rare findings during endoscopy and even though their symptomatology is usually subtle, they may cause significant symptoms such as bleeding and anemia. Growing evidence suggests they have malignant potential which is associated with other factors such as their size, that can be used clinically to assist with their management.