Analyzing The Pathological Patterns And Risk Factors Of Gastric Polyps

Objective: To analyze the pathological patterns and risk factors of gastric polyps and to provide clinical basis for the diagnosis and treatment of gastric polyps based on the study of the clinical features and related information of patients with gastric polyps hospitalized in Inpatient Department,the Second Hospital of Dalian Medical University.Methods: 1.Patient Group: A total of 300 cases of patients undergone gastroscopy and pathologically diagnosed with gastric polyps in the Second Hospital of Dalian Medical University from October 15,2015 to April 21,2016 were selected according to the admission and examination time.2.Control Group: A total of 300 cases of patients undergone gastroscopy and diagnosed with chronic gastritis in the Second Hospital of Dalian Medical University from October 15,2015 to March 12,2016 were selected according to the admission and examination time.3.Patients with Peutz-Jeghers syndrome,genetic polypus and advanced gastric carcinoma and those undergone subtotal gastrectomy were excluded from this data.4.Statistical approaches: SPSS13.0 was adopted for statistics,chi square test was done on enumeration data,p<0.05 suggested that the difference was statistically significant.The correlation was analyzed using multivariate non-conditional logistic regression,and the odds ratio(OR)and 95% CI were calculated.As to the results,the difference was statistically significant when P<0.05.Results:(1)Statistical results of general data of research objects 1.Gastric polyps of different pathological patterns from high to low proportions are,in order,hyperplastic polyps(46.33%),fundic gland polyps(29%),inflammatory polyps(19%)and adenomatous polyps(6.33%).2.In the Patient Group,patients with inflammatory polyps were aged 26 to 79,including 38 females(66.67%)and19 males(33.33%)and with the average age of 53.67±11.65.Patients with hyperplastic polyps were aged 20 to 83,including 85 females(61.15%)and 54 males(38.85%)and with the average age of 56.27±12.31.Patients with fundic gland polyps were aged 19 to 83,including 54 females(62.07%)and 33 males(37.93%)and with the average age of 53.18±12.94.Patients with adenomatous polyps were aged 54 to 84,including 5 females(26.32%)and 14 males(73.68%)and with the average age of 68.16±9.40;in the Control Group,patients were aged 15 to 87,including 167 females(63.37%)and 133 males(36.33%)and with the average age of 53.31±11.51.3.All the patients were divided into 8 age groups according to their age,namely,below 20 Y/O group,21-31 Y/O group,31-40 Y/O group,41-50 Y/O group,51-60 Y/O group,61-70 Y/O group,71-80 Y/O group and above 81 Y/O group.Among patients with inflammatory polyps,the number of those included into 41-50 Y/O group was the largest,and those aged above 40 accounted for 89.47%;among patients with hyperplastic polyps,the number of those included into 51-60 Y/O group was the largest,and those aged above 50 accounted for 71.94%;among patients with fundic gland polyps,the number of those included into 41-50 Y/O group was the largest,and those aged above 40 accounted for 87.36%;among patients with adenomatous polyps,the number of those included into 61-70 Y/O group was the most,and those aged above 60 accounted for 73.58%;in Control Group,the number of patients included into 51-60 Y/O group was the most,and patients aged above 40,above 50 and above 60 accounted for 88.67%,57.33% and 24.67%,respectively.4.The average onset age of adenomatous polyps is higher than that of other three types of polyps,and adenomatous polyps mostly stike males?(2)Analysis results of related risk factors 2.1.Inflammatory polyp group versus Control Group: the single factor chi-square test results showed that,the value of H.pylori infection was higher than in Control Group,and the difference was statistically significant(p=0.024);the results of logistic regression analysis suggested that,the risk factor easily causing inflammatory polyp is H.pylori infection(p=0.027),and the odds ratio(OR)value of the risk factor is 2.076(95%CI=1.089-3.960).2.2.Hyperplastic polyp group versus Control Group: the single factor chi-square test results showed that,the values of age(above 50 Y/O),H.pylori infection and gastrointestinal reflux were higher than in Control Group,and the difference was statistically significant(p=0.003,0.001,0.019);the results of logistic regression analysis suggested that,risk factors easily causing hyperplastic polyps include H.pylori infection(95%CI:1.410-3.630),gastrointestinal reflux(95%CI:1.278-3.748)and age(95%CI:1.097-2.683),and the odds ratio(OR)values are 2.255,2.189 and 1.716,respectively: 2.3.Fundic gland polyp group versus Control Group: the single factor chi-square test results showed that,the values of proton pump inhibitors(PPIs)and H.pylori infection were higher than in Control Group,and the difference was statistically significant(p=0.010,0.038);the results of logistic regression analysis suggested that,risk factors easily causing fundic gland polyp include PPIs and H.pylori infection(p=0.005,0.015),but PPIs are positively correlated with fundic gland polyps,H.pylori infection is negatively correlated with fundic gland polyps;the OR value of PPIs(OR=2.063,95%CI:1.237-3.440)is larger than that of H.pylori infection(OR=0.533,95%CI: 0.321-0.884).2.4.Adenomatous polyp group versus Control Group: the single factor chi-square test results showed that,the values of gender,age,smoking,H.pylori infection,gastrointestinal reflux and chronic atrophic gastritis were higher than in Control Group,and the difference was statistically significant(p=0.013,<0.001,0.035,0.010,0.038,<0.001);the results of logistic regression analysis suggested that,from large OR value to small OR value,risk factors easily causing adenomatous polyp are,in order,chronic atrophic gastritis(OR=5.307,95%CI:1.716-16.41),age(OR=0.4.751,95%CI:1.474-15.32)and gastrointestinal reflux(OR=3.647,95% CI:1.147-11.60).Conclusion: 1.From large proportion to small proportion,pathological patterns of gastric polyps are,in order,hyperplastic polyps,fundic gland polyps,inflammatory polyps and adenomatous polyps.Hyperplastic polyps and fundic gland polyps are common in females,and adenomatous polyps are common in aged males.The average onset age of adenomatous polyps is higher than that of other three types of polyps,and adenomatous polyps mostly stike males? 2.HP infection,duodenogastric reflux and age(above 50 Y/O)are risk factors of hyperplastic polyps,and HP infection poses the largest risk,followed by duodenogastric reflux and age(above 50 Y/O).HP infection may not only involve in the oncome of hyperplastic polyps,but also be related to canceration.It is suggested that active treatment of hyperplastic polyps should be adopted,HP testing be carried out and corresponding treatment be provided..Fundic gland polyp is positively correlated with the administration of PPIs and negatively correlated with HP infection,Inflammatory polyp is positively correlated with HP infection.Age(above 60 Y/O),chronic atrophic gastritis and duodenogastric reflux are risk factors of adenomatous polyps,and chronic atrophic gastritis poses the largest risk,followed by age(above 60 Y/O)and duodenogastric reflux.