BACKGROUND Hyperplastic polyps,which represent 30%-93%of all gastric epithelial polyps,are the second most common type of gastric polyps after fundic gland polyps.They were previously considered to have no risk of neo...BACKGROUND Hyperplastic polyps,which represent 30%-93%of all gastric epithelial polyps,are the second most common type of gastric polyps after fundic gland polyps.They were previously considered to have no risk of neoplastic transformation.Recently,an increasing number of cases of gastric hyperplastic polyps(GHPs)combined with neoplastic changes have been reported;however,the specific mechanism underlying their transformation has not been thoroughly explored.AIM To investigate the clinical,endoscopic,and pathological characteristics of the neoplastic transformation of GHPs and explore the risk factors.METHODS A retrospective analysis was performed on 4010 cases of GHPs diagnosed by gastroscopy and pathological examination at the hospital from 2005 to 2021.In total,3874,119,and 17 cases were in the group without intraepithelial neoplasia(IN),with low-grade IN,and with high-grade IN,respectively.The data analysis examined the association of endoscopic and pathological features with risk factors for neoplastic transformation.Factors with significant differences were entered into univariate logistic regression,followed by multivariate logistic regression analysis.RESULTS Univariate analysis revealed diameter,multiple polyp presence,redness,rough surface,lobulation,erosion,Yamada classification,location,and gastric mucosa were risk factors for neoplastic transformation.Multivariate analysis showed that age>65 years[odds ratio(OR)=1.789;95%confidence interval(CI):1.227-2.609;P=0.003],male sex(OR=1.680;95%CI:1.158-2.438;P=0.006),multiple polyps(OR=1.851;95%CI:1.230-2.784;P=0.003),pedunculated or semi-pedunculated shape(OR=2.722;95%CI:1.689-4.388;P<0.001),and polyp diameter were significantly associated with GHPs that demonstrated neoplastic transformation.Compared with chronic superficial gastritis,autoimmune gastritis,atrophic gastritis,and gastritis with IN were independent risk factors for neoplastic transformation[(OR=2.672;95%CI:1.559-4.579;P<0.001),(OR=1.876;95%CI:1.134-3.103;P=0.014),and(OR=5.299;95%CI:3.173–8.849;P<0.001),respectively].CONCLUSION Male sex,age>65 years,multiple polyps,pedunculated or semi-pedunculated shape,polyp size>1 cm,and specific background gastric mucosa are key indicators for predicting neoplastic transformation of GHPs.展开更多
We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precan...We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precancerous lesion; and adenocarcinoma arises from hyperplastic polyposis through the hyperplastic polyp-adenoma-carcinoma sequence. Most polyps in patients with hyperplastic polyposis present as bland- looking hyperplastic polyps, which are regarded as non- neoplastic lesions; however, the risk of malignancy should not be underestimated. In patients with multiple hyperplastic polyps, hyperplastic polyposis should be identified and followed up carefully in order to detect malignant transformation in the early stage.展开更多
Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation o...Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori(H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.展开更多
AIM： To study the effects of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori （H pylori. METHODS： Forty-eight patients with hyperplasticgastric polyps （3-10 mm in diameter） infected...AIM： To study the effects of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori （H pylori. METHODS： Forty-eight patients with hyperplasticgastric polyps （3-10 mm in diameter） infected with Hpylori were randomly assigned to a treatment group （n = 24） which received proton-pump inhibitor （omeprazole or lansoprazole）, clarithromycin, bismuth citrate and tinidazole, and a control group （n = 24） which received protective agent of gastric mucosa （tepretone） . Patients underwent endoscopy and H pylori examination regularly before enrollmentand 1-12 mo after treatment. RESULTS： Twenty-two patients in the treatment group and 21 in the control group completed the entire test protocol. In the treatment group, polyps disappeared 1-12 mo （average, 6.5 ± 1.1 too） after the treatment in 15 of 22 patients （68.2%） and H pylori infection was eradicated in 19 of the 22 patients （86.4%）. However, 12 months after the study, no change in polyps or H pylori status was seen in any controls （^bp 〈 0.01）. CONCLUSION： Most hyperplastic gastric polyps disappear after eradication of H pylori.展开更多
AIM To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and colorectal adenomatous and hyperplastic polyps.METHODS A retrospective cross-sectional study was conducted on 3686 individuals u...AIM To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and colorectal adenomatous and hyperplastic polyps.METHODS A retrospective cross-sectional study was conducted on 3686 individuals undergoing health checkups(2430 males and 1256 females). All subjects underwent laboratory testing,abdominal ultrasonography,colonoscopy,and an interview to ascertain the baseline characteristics and general state of health. Multinomial logistic regression analysis was performed to examine the association between NAFLD and the prevalence of colorectal adenomatous and hyperplastic polyps.Furthermore,the relationship was analyzed in different sex groups. Subgroup analysis was performed based on number,size,and location of colorectal polyps.RESULTS The prevalence of colorectal polyps was 38.8% in males(16.2% for adenomatous polyps and 9.8% for hyperplastic polyps) and 19.3% in females(8.4% for adenomatous polyps and 3.9% for hyperplastic polyps). When adjusting for confounding variables,NAFLD was significantly associated with the prevalence of adenomatous polyps(OR = 1.28,95%CI: 1.05-1.51,P < 0.05) and hyperplastic polyps(OR = 1.35,95%CI: 1.01-1.82,P < 0.05). However,upon analyzing adenomatous and hyperplastic polyps in different sex groups,the significant association remained in males(OR = 1.53,95%CI: 1.18-2.00,P < 0.05; OR = 1.42,95%CI: 1.04-1.95,P < 0.05) but not in females(OR = 0.44,95%CI: 0.18-1.04,P > 0.05; OR = 1.18,95%CI: 0.50-2.78,P > 0.05). CONCLUSION NAFLD is specifically associated with an increased risk of colorectal adenomatous and hyperplastic polyps in men. However,NAFLD may not be a significant factor in the prevalence of colorectal polyps in women.展开更多
The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, ...The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, we describe a case of a white opaque substance (WOS)positive gastric HP with dysplasia. A 76-year-old woman was referred to our hospital for endoscopic resection of a gastric HP. Upper endoscopy revealed a 25-mm whitish and reddish polypoid lesion on the greater curvature in the lower third of the stomach. The whitish part was diagnosed as a WOS using conventional and magnifying endoscopy with narrow band imaging. An examination of the biopsy specimen indicated that the lesion was a typical gastric HP. However, because of its color and the presence of a WOS, we suspected that this lesion was an atypical gastric HP. Therefore, we performed a polypectomy. Histopathologically, diffuse lowto high-grade dysplasia was found on the surface of the polyp. We performed immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipid droplets (LDs). LDs were detected in approximately all of the neoplastic cells, especially in the surface epithelium of the intervening apical parts and were located in the subnuclear cytoplasm of the neoplastic cells. According to endoscopic and histopathological findings, the WOS-positive epithelium indicated dysplasia of the gastrointestinal phenotype, which could absorb lipids. The presence of a WOS in a gastric HP may be considered an endoscopic finding that is predictive of the neoplastic transformation of a gastric HP. We suggest that a WOS-positive gastric HP should be resected endoscopically to investigate its neoplastic transformation.展开更多
Objective: To study the effect of Shugan Shuru Granule (疏肝舒乳颗粒,SSG) on the p53 gene expression in patients with hyperplastic disease of breast (HDB) to indirectly explore the mechanism of SSG’s effect on HDB on...Objective: To study the effect of Shugan Shuru Granule (疏肝舒乳颗粒,SSG) on the p53 gene expression in patients with hyperplastic disease of breast (HDB) to indirectly explore the mechanism of SSG’s effect on HDB on the molecular pathological level. Methods: Sixty-six patients with HDB were allocated in the treated group and the control group,with the former treated with SSG and the latter not. All patients underwent breast operation and their diseased mammary tissues were cut out, sectioned, and observed under microscopy with HE staining and immunohistochemical staining, with ABC method adopted to estimate the degree of hyperplasia and p53 gene expression. The severity of HDB was classified into normal, mild, moderate and severe grades (marked as 0 to Ⅲ), according to the degree of hyperplasia in the mammary gland. Results: Hyperplasia in the control group mostly belonged to grade Ⅰ-Ⅲ before treatment, showing overgrowth of gland and proliferation of glandular epithelial cells, which were high columnar shaped, more stratified, with papillary or substantive dysplasia. While in the treated group, most belonged to grade 0-Ⅰ after SSG treatment, with proliferated gland and dysplasia recovered to normal or disappeared. The positive rate of p53 gene expression in the treated group was 9.09%, and in the control group 39.39%, comparison between the two groups showing significant difference (P<0.01), the intensity in the former was significantly weaker than that in the latter.Conclusion: SSG could not only inhibit the proliferation of mammary duct epithelia and lobuli, but also inhibit the over-expression of P53. Therefore, it could be regarded as an effective remedy for treatment of HDB and prevention of mammary cancer genesis.展开更多
Here, we report a case of a young man who presented with a significant upper gastrointestinal bleed treated by endoscopic removal of multiple hyperplastic polyps. Gastric hyperplastic polyps are a relatively uncommon ...Here, we report a case of a young man who presented with a significant upper gastrointestinal bleed treated by endoscopic removal of multiple hyperplastic polyps. Gastric hyperplastic polyps are a relatively uncommon cause of overt gastrointestinal bleeding. While most hyperplastic gastric polyps are asymptomatic, they may present with abdominal pain, iron def iciency anemia or gastric outlet obstruction. These polyps are associated with conditions such as Helicobacter pylori gastritis and atrophic autoimmune gastritis, which predispose the epithelium to chronic inf lammation and epithelial repair.The patient presented to Northwestern Memorial Hospital in July 2011. The polyps were resected by clip-assisted snare polypectomy. Histopathologic assessment of the resected polyps demonstrated multiple, nonulcerative hyperplastic polyps measuring 1.3-1.8 cm in size, without evidence of dysplasia or malignancy. This case describes a young adult patient with multiple, large gastric polyps causing overt gastrointestinal bleeding. This is a rare presentation in a young individual, as these polyps are typically identifi ed in patients older than 60 years of age and less commonly, pediatric populations.展开更多
AIM:To evaluate the diagnostic value of panoramic immersion B-scan ultrasonography(Pano-immersion B-scan,PIB)in complex retinal detachment(RD),persistent hyperplastic primary vitreous(PHPV)and intraocular tumors.METHO...AIM:To evaluate the diagnostic value of panoramic immersion B-scan ultrasonography(Pano-immersion B-scan,PIB)in complex retinal detachment(RD),persistent hyperplastic primary vitreous(PHPV)and intraocular tumors.METHODS:The clinical data of 44 patients collected from May 2012 to December 2019 in Chinese PLA General Hospital was retrospectively studied.All of these patients underwent PIB of the eye,because it was difficult to diagnose by routine ocular fundus examination,conventional ultrasound or/and ultrasonic biomicroscope(UBM)due to opacity of refractive media,pupillary occlusion,large involvement or special location of the lesion.The imaging features of difficult cases in PIB were analyzed.The diagnosis accuracy rating of PIB were evaluated and contrasted with conventional ultrasound or UBM by the standard of intraoperative diagnosis or/and pathological results.RESULTS:According to intraoperative diagnosis or pathological results as gold standard,among the 44 cases,there were 19 cases missed diagnosis,misdiagnosed or difficult-to-diagnose by conventional ultrasound or UBM,including 4 cases of long-standing RD difficult to diagnose,4 cases misdiagnosed,and 11 cases incompletely observed or miss diagnosed.The diagnostic accuracy rate of PIB and conventional ultrasound or UBM were 100%(44/44)and 56.82%(25/44),and the sensitivity of them were 100%and 56.82%.All the patients underwent PIB and were diagnosed as RD(15 cases),retinal and choroidal detachment(4 cases),subchoroidal hematocele(1 case),vitreous opacity and/or organic membrane formation(4 cases),PHPV(12 cases),iris and/or ciliary body tumors(3 cases),and choroidal tumors(6 cases).According to the intraoperative diagnosis or pathological results,the diagnostic coincidence rate of PIB was 100%,which was significantly higher than conventional ultrasound and UBM.CONCLUSION:PIB can help to accurately diagnose complex RD,PHPV,and intraocular masses with special location or/and excessive size.It has important diagnostic value for patients with equivocal findings at conventional ultrasound examination.展开更多
AIM：To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous（PHPV）.METHODS：This retrospective study included patients with cataract and PHPV treated...AIM：To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous（PHPV）.METHODS：This retrospective study included patients with cataract and PHPV treated with various strategies.Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization,posterior capsulotomy,anterior vitrectomy,and intraocular lens（IOL）implantation. Posterior PHPV was treated with lensectomy,posterior vitrectomy,retinal photocoagulation,and IOL implantation or silicone oil tamponade. Visual acuity（VA）,pattern visual evoked potential（P-VEP）,anatomic recovery,postoperative complications,and amblyopia outcome were examined.Subjects were followed-up for 3-48 mo after surgery.RESULTS：Of the 30 patients（33 eyes）with congenital cataract and PHPV included（average age,39.30±35.47mo）,9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage（6 eyes）and twostage（3 eyes）implantation. Postoperative complications included retinal detachment（1 eye）and recurrent anterior chamber hemorrhage（1 eye）. In eyes with posterior PHPV,6 and 11 eyes received IOLs in one-and two-stage procedures,respectively. Silicone oil was retained in 2 eyes,and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48 mo of amblyopia treatment. P-VEP P_（100） was improved following surgery in both PHPV types.CONCLUSION：Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.展开更多
Colonic lipomas are submucosal nonepithelial tumors covered by intact or eroded mucosa. In rare cases, alterations in the mucosa covering a lipoma include hyperplasia, adenoma, atrophy, ulceration, and necrosis. Here,...Colonic lipomas are submucosal nonepithelial tumors covered by intact or eroded mucosa. In rare cases, alterations in the mucosa covering a lipoma include hyperplasia, adenoma, atrophy, ulceration, and necrosis. Here, we report a case of a colonic lipoma covered by hyperplastic epithelium in a 68-year-old woman. Based on the colonoscopy findings, a snare polypectomy was performed for a presumptive diagnosis of an epithelial lesion; however, the histological examination revealed a colonic submucosal lipoma with overlying hyperplastic epithelium.展开更多
A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas...A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas were identified. On endoscopy, multiple hyperplastic polyps were seen in the rectum and left-side colon. There were also esophageal glycogenic acanthosis and hyperplastic polyposis in the antrum accompanied by Helicobacter pylorirelated gastritis. Although gastric hyperplastic polyposis had by no means regressed with unsuccessful first-line eradication therapy for H pylori, following cure of the infection with salvage therapy consisting of rabeprazole,amoxicillin and metronidazole, the polyposis lesions almost disappeared. Follow-up gastroscopy 2 and 3 years after cessation of the second-line eradication therapy revealed almost complete regression of the polyposis lesions with no evidence of H pylori infection. We recommend eradication treatment for CD patients with gastric hyperplastic polyps and the infection, as the occurrence of gastric carcinoma among hyperplastic polyps has been described.展开更多
Acalculous gallbladder diseases do not draw too much attention from researchers because of their low incidence of malignancy, no symptoms, and good prognosis, and therefore there is even no unanimous terminology. Emerged
AIM： To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophagogastric junction （EGJ） associated with Barrett＇s esophagus （BE） with low-grade dysplasia （LGD）, by endoscopic r...AIM： To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophagogastric junction （EGJ） associated with Barrett＇s esophagus （BE） with low-grade dysplasia （LGD）, by endoscopic rnucosal resection （EMR）. METHODS： Cap fitted EMR （EMR-C） was performed in 3 patients with hyperplastic-inflammatory polyps （HIPs） and BE. RESULTS： The polyps were successfully removed in the 3 patients. In two patients, with short segment BE （SSBE） （≤ 3 cm）, the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm × 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous reepithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR. CONCLUSION： EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.展开更多
Precisely distinguishing between hyperplastic and adenomatous polyps and normal human colonic mucosa at the cellular level is of great medical significance.In this work,multiphoton laserscarming microscopy(MPLSM)was u...Precisely distinguishing between hyperplastic and adenomatous polyps and normal human colonic mucosa at the cellular level is of great medical significance.In this work,multiphoton laserscarming microscopy(MPLSM)was used to obtain the high.-contrast images and the morpho-logical characteristics from normal colonic mucosa,hyperplastic polyps and tubular adenoma.Byintegrating the length and area measurement tools and computing tool,we quantified thedifference of crypt morphology and the alteration of nuclei in normal and diseased human colonicmucosa.Our results demonstrated that the morphology of crypts had an obvious tendency tocystic dilatation or elongated in hyperplastic polyps and tubular adenoma.The cont ent andnumber of mucin droplets of the scattered goblet cells had a piecemeal reduction in hyperplastic polyps and a large decrease in tubular adenoma The nuclei of epithelial cells might be elongated and pseudostratified,but overt dysplasia was absent in hyperplastic polyps.Nevertheless,thenuclei showed enlarged,crowded,stratified and a rod-like structure,with loss of polarity intubular adenoma.These results suggest that MPLSM has the capacity to distinguish betweenhyperplastic and adenomat ous polyps and normal human colonic mucosa at the celular level.展开更多
With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming a...With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.展开更多
BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high ma...BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high malignant potential,HPs have a low risk of potential harm,whereas sporadic FGPs have no malignant potential.It is not enough to determine the type and displacement of a polyp by biopsy alone;therefore,some polyps may require an extensive biopsy or complete resection.AIM To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.METHODS This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.RESULTS In a series of 10000 patients who underwent upper gastrointestinal endoscopy,384(3.84%)had GPs.There were 98 males(25.5%)and 286 females(74.5%).The mean age of patients was 62.8±10.4(36-75)years.The frequencies of HPs,APs,and FGPs were 88.5%,5.2%,and 2.1%,respectively.The polyp size of 274 patients(71.3%)was≤1 cm.Polyps were found in 262 cases(68.2%).The most common sites for polyps were the lumen and body of the intestine.Endoscopic polypectomy was performed in 128 patients.Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.CONCLUSION The incidence of GPs was low.HPs were the most common types of GPs.Of note,as GPs have the potential to develop into adenocarcinoma or precancerous lesions,we suggest that appropriate GP resection technology(e.g.,biopsy forceps or mesenchymal resection)be applied.展开更多
In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and the...In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and their prevalence remains unclear.Most GBPs in children are benign,and although the risk of malignancy is influenced by polyp size,growth rate,and morphology,specific criteria for the pediatric population are lacking.Management,therefore,is based on adult guidelines,with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation,while surveillance is applied to asymptomatic patients with smaller polyps.Further research is needed to develop pediatric-specific guidelines for the management of GBPs.This review discusses the classification,diagnosis,risk factors,and management of pediatric GBPs.展开更多
This paper reports a rare case of early adenocarcinoma within the gastric hyperplastic polyp,that was completely resected during an endoscopic procedure,and discusses current recommendations in such cases.Endoscopic r...This paper reports a rare case of early adenocarcinoma within the gastric hyperplastic polyp,that was completely resected during an endoscopic procedure,and discusses current recommendations in such cases.Endoscopic resection of polyps with focal dysplasia or cancer is commonly indicated,as long as the procedure can be performed safely.After complete excision of a polyp with atypical focal lesion,endoscopic surveillance is suggested.The frequency of surveillance endoscopy should depend on the precise histopathological diagnosis and possibility of confirming the completeness of the endoscopic resection.If the completeness of the procedure is confirmed both macro-and microscopically,gastric resection does not have to be performed.A follow-up esophago-gastroduodenoscopy should be performed at 1 year and then at 3 years.展开更多
To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cas...To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cases of AHN were investigated by PDS an d the findings were campared with those of digital subtraction angiography (DSA) Results The rates of arterial and portal flow in an afferent tumor vessel were 86 4% a n d 40 9% in SHCCs, respectively The rate of portal flow in an afferent tumor v essel was 60 0% in AHNs, while no arterial flow was detected ( P <0 01) In addition, PDS revealed a constant flow in an efferent tumor vessel (50 0%) c ontinuing to a portal branch in 10 (45 5%) of the 22 SHCCs cases to a hepatic v ein in 1 (4 5%) of the 22 SHCCs, but to nothing else in the AHNs ( P <0 01) Conclusions Power Doppler sonography is of value in distinguishing SHCC from AHN, and arteri al afferent tumor vessels from constant flow efferent tumor vessels at PDS展开更多
文摘BACKGROUND Hyperplastic polyps,which represent 30%-93%of all gastric epithelial polyps,are the second most common type of gastric polyps after fundic gland polyps.They were previously considered to have no risk of neoplastic transformation.Recently,an increasing number of cases of gastric hyperplastic polyps(GHPs)combined with neoplastic changes have been reported;however,the specific mechanism underlying their transformation has not been thoroughly explored.AIM To investigate the clinical,endoscopic,and pathological characteristics of the neoplastic transformation of GHPs and explore the risk factors.METHODS A retrospective analysis was performed on 4010 cases of GHPs diagnosed by gastroscopy and pathological examination at the hospital from 2005 to 2021.In total,3874,119,and 17 cases were in the group without intraepithelial neoplasia(IN),with low-grade IN,and with high-grade IN,respectively.The data analysis examined the association of endoscopic and pathological features with risk factors for neoplastic transformation.Factors with significant differences were entered into univariate logistic regression,followed by multivariate logistic regression analysis.RESULTS Univariate analysis revealed diameter,multiple polyp presence,redness,rough surface,lobulation,erosion,Yamada classification,location,and gastric mucosa were risk factors for neoplastic transformation.Multivariate analysis showed that age>65 years[odds ratio(OR)=1.789;95%confidence interval(CI):1.227-2.609;P=0.003],male sex(OR=1.680;95%CI:1.158-2.438;P=0.006),multiple polyps(OR=1.851;95%CI:1.230-2.784;P=0.003),pedunculated or semi-pedunculated shape(OR=2.722;95%CI:1.689-4.388;P<0.001),and polyp diameter were significantly associated with GHPs that demonstrated neoplastic transformation.Compared with chronic superficial gastritis,autoimmune gastritis,atrophic gastritis,and gastritis with IN were independent risk factors for neoplastic transformation[(OR=2.672;95%CI:1.559-4.579;P<0.001),(OR=1.876;95%CI:1.134-3.103;P=0.014),and(OR=5.299;95%CI:3.173–8.849;P<0.001),respectively].CONCLUSION Male sex,age>65 years,multiple polyps,pedunculated or semi-pedunculated shape,polyp size>1 cm,and specific background gastric mucosa are key indicators for predicting neoplastic transformation of GHPs.
文摘We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precancerous lesion; and adenocarcinoma arises from hyperplastic polyposis through the hyperplastic polyp-adenoma-carcinoma sequence. Most polyps in patients with hyperplastic polyposis present as bland- looking hyperplastic polyps, which are regarded as non- neoplastic lesions; however, the risk of malignancy should not be underestimated. In patients with multiple hyperplastic polyps, hyperplastic polyposis should be identified and followed up carefully in order to detect malignant transformation in the early stage.
文摘Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori(H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.
文摘AIM： To study the effects of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori （H pylori. METHODS： Forty-eight patients with hyperplasticgastric polyps （3-10 mm in diameter） infected with Hpylori were randomly assigned to a treatment group （n = 24） which received proton-pump inhibitor （omeprazole or lansoprazole）, clarithromycin, bismuth citrate and tinidazole, and a control group （n = 24） which received protective agent of gastric mucosa （tepretone） . Patients underwent endoscopy and H pylori examination regularly before enrollmentand 1-12 mo after treatment. RESULTS： Twenty-two patients in the treatment group and 21 in the control group completed the entire test protocol. In the treatment group, polyps disappeared 1-12 mo （average, 6.5 ± 1.1 too） after the treatment in 15 of 22 patients （68.2%） and H pylori infection was eradicated in 19 of the 22 patients （86.4%）. However, 12 months after the study, no change in polyps or H pylori status was seen in any controls （^bp 〈 0.01）. CONCLUSION： Most hyperplastic gastric polyps disappear after eradication of H pylori.
文摘AIM To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and colorectal adenomatous and hyperplastic polyps.METHODS A retrospective cross-sectional study was conducted on 3686 individuals undergoing health checkups(2430 males and 1256 females). All subjects underwent laboratory testing,abdominal ultrasonography,colonoscopy,and an interview to ascertain the baseline characteristics and general state of health. Multinomial logistic regression analysis was performed to examine the association between NAFLD and the prevalence of colorectal adenomatous and hyperplastic polyps.Furthermore,the relationship was analyzed in different sex groups. Subgroup analysis was performed based on number,size,and location of colorectal polyps.RESULTS The prevalence of colorectal polyps was 38.8% in males(16.2% for adenomatous polyps and 9.8% for hyperplastic polyps) and 19.3% in females(8.4% for adenomatous polyps and 3.9% for hyperplastic polyps). When adjusting for confounding variables,NAFLD was significantly associated with the prevalence of adenomatous polyps(OR = 1.28,95%CI: 1.05-1.51,P < 0.05) and hyperplastic polyps(OR = 1.35,95%CI: 1.01-1.82,P < 0.05). However,upon analyzing adenomatous and hyperplastic polyps in different sex groups,the significant association remained in males(OR = 1.53,95%CI: 1.18-2.00,P < 0.05; OR = 1.42,95%CI: 1.04-1.95,P < 0.05) but not in females(OR = 0.44,95%CI: 0.18-1.04,P > 0.05; OR = 1.18,95%CI: 0.50-2.78,P > 0.05). CONCLUSION NAFLD is specifically associated with an increased risk of colorectal adenomatous and hyperplastic polyps in men. However,NAFLD may not be a significant factor in the prevalence of colorectal polyps in women.
文摘The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, we describe a case of a white opaque substance (WOS)positive gastric HP with dysplasia. A 76-year-old woman was referred to our hospital for endoscopic resection of a gastric HP. Upper endoscopy revealed a 25-mm whitish and reddish polypoid lesion on the greater curvature in the lower third of the stomach. The whitish part was diagnosed as a WOS using conventional and magnifying endoscopy with narrow band imaging. An examination of the biopsy specimen indicated that the lesion was a typical gastric HP. However, because of its color and the presence of a WOS, we suspected that this lesion was an atypical gastric HP. Therefore, we performed a polypectomy. Histopathologically, diffuse lowto high-grade dysplasia was found on the surface of the polyp. We performed immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipid droplets (LDs). LDs were detected in approximately all of the neoplastic cells, especially in the surface epithelium of the intervening apical parts and were located in the subnuclear cytoplasm of the neoplastic cells. According to endoscopic and histopathological findings, the WOS-positive epithelium indicated dysplasia of the gastrointestinal phenotype, which could absorb lipids. The presence of a WOS in a gastric HP may be considered an endoscopic finding that is predictive of the neoplastic transformation of a gastric HP. We suggest that a WOS-positive gastric HP should be resected endoscopically to investigate its neoplastic transformation.
文摘Objective: To study the effect of Shugan Shuru Granule (疏肝舒乳颗粒,SSG) on the p53 gene expression in patients with hyperplastic disease of breast (HDB) to indirectly explore the mechanism of SSG’s effect on HDB on the molecular pathological level. Methods: Sixty-six patients with HDB were allocated in the treated group and the control group,with the former treated with SSG and the latter not. All patients underwent breast operation and their diseased mammary tissues were cut out, sectioned, and observed under microscopy with HE staining and immunohistochemical staining, with ABC method adopted to estimate the degree of hyperplasia and p53 gene expression. The severity of HDB was classified into normal, mild, moderate and severe grades (marked as 0 to Ⅲ), according to the degree of hyperplasia in the mammary gland. Results: Hyperplasia in the control group mostly belonged to grade Ⅰ-Ⅲ before treatment, showing overgrowth of gland and proliferation of glandular epithelial cells, which were high columnar shaped, more stratified, with papillary or substantive dysplasia. While in the treated group, most belonged to grade 0-Ⅰ after SSG treatment, with proliferated gland and dysplasia recovered to normal or disappeared. The positive rate of p53 gene expression in the treated group was 9.09%, and in the control group 39.39%, comparison between the two groups showing significant difference (P<0.01), the intensity in the former was significantly weaker than that in the latter.Conclusion: SSG could not only inhibit the proliferation of mammary duct epithelia and lobuli, but also inhibit the over-expression of P53. Therefore, it could be regarded as an effective remedy for treatment of HDB and prevention of mammary cancer genesis.
文摘Here, we report a case of a young man who presented with a significant upper gastrointestinal bleed treated by endoscopic removal of multiple hyperplastic polyps. Gastric hyperplastic polyps are a relatively uncommon cause of overt gastrointestinal bleeding. While most hyperplastic gastric polyps are asymptomatic, they may present with abdominal pain, iron def iciency anemia or gastric outlet obstruction. These polyps are associated with conditions such as Helicobacter pylori gastritis and atrophic autoimmune gastritis, which predispose the epithelium to chronic inf lammation and epithelial repair.The patient presented to Northwestern Memorial Hospital in July 2011. The polyps were resected by clip-assisted snare polypectomy. Histopathologic assessment of the resected polyps demonstrated multiple, nonulcerative hyperplastic polyps measuring 1.3-1.8 cm in size, without evidence of dysplasia or malignancy. This case describes a young adult patient with multiple, large gastric polyps causing overt gastrointestinal bleeding. This is a rare presentation in a young individual, as these polyps are typically identifi ed in patients older than 60 years of age and less commonly, pediatric populations.
文摘AIM:To evaluate the diagnostic value of panoramic immersion B-scan ultrasonography(Pano-immersion B-scan,PIB)in complex retinal detachment(RD),persistent hyperplastic primary vitreous(PHPV)and intraocular tumors.METHODS:The clinical data of 44 patients collected from May 2012 to December 2019 in Chinese PLA General Hospital was retrospectively studied.All of these patients underwent PIB of the eye,because it was difficult to diagnose by routine ocular fundus examination,conventional ultrasound or/and ultrasonic biomicroscope(UBM)due to opacity of refractive media,pupillary occlusion,large involvement or special location of the lesion.The imaging features of difficult cases in PIB were analyzed.The diagnosis accuracy rating of PIB were evaluated and contrasted with conventional ultrasound or UBM by the standard of intraoperative diagnosis or/and pathological results.RESULTS:According to intraoperative diagnosis or pathological results as gold standard,among the 44 cases,there were 19 cases missed diagnosis,misdiagnosed or difficult-to-diagnose by conventional ultrasound or UBM,including 4 cases of long-standing RD difficult to diagnose,4 cases misdiagnosed,and 11 cases incompletely observed or miss diagnosed.The diagnostic accuracy rate of PIB and conventional ultrasound or UBM were 100%(44/44)and 56.82%(25/44),and the sensitivity of them were 100%and 56.82%.All the patients underwent PIB and were diagnosed as RD(15 cases),retinal and choroidal detachment(4 cases),subchoroidal hematocele(1 case),vitreous opacity and/or organic membrane formation(4 cases),PHPV(12 cases),iris and/or ciliary body tumors(3 cases),and choroidal tumors(6 cases).According to the intraoperative diagnosis or pathological results,the diagnostic coincidence rate of PIB was 100%,which was significantly higher than conventional ultrasound and UBM.CONCLUSION:PIB can help to accurately diagnose complex RD,PHPV,and intraocular masses with special location or/and excessive size.It has important diagnostic value for patients with equivocal findings at conventional ultrasound examination.
基金Supported by the Science and Technology Research Projects of Henan Province,China(No.201202010)
文摘AIM：To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous（PHPV）.METHODS：This retrospective study included patients with cataract and PHPV treated with various strategies.Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization,posterior capsulotomy,anterior vitrectomy,and intraocular lens（IOL）implantation. Posterior PHPV was treated with lensectomy,posterior vitrectomy,retinal photocoagulation,and IOL implantation or silicone oil tamponade. Visual acuity（VA）,pattern visual evoked potential（P-VEP）,anatomic recovery,postoperative complications,and amblyopia outcome were examined.Subjects were followed-up for 3-48 mo after surgery.RESULTS：Of the 30 patients（33 eyes）with congenital cataract and PHPV included（average age,39.30±35.47mo）,9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage（6 eyes）and twostage（3 eyes）implantation. Postoperative complications included retinal detachment（1 eye）and recurrent anterior chamber hemorrhage（1 eye）. In eyes with posterior PHPV,6 and 11 eyes received IOLs in one-and two-stage procedures,respectively. Silicone oil was retained in 2 eyes,and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48 mo of amblyopia treatment. P-VEP P_（100） was improved following surgery in both PHPV types.CONCLUSION：Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.
文摘Colonic lipomas are submucosal nonepithelial tumors covered by intact or eroded mucosa. In rare cases, alterations in the mucosa covering a lipoma include hyperplasia, adenoma, atrophy, ulceration, and necrosis. Here, we report a case of a colonic lipoma covered by hyperplastic epithelium in a 68-year-old woman. Based on the colonoscopy findings, a snare polypectomy was performed for a presumptive diagnosis of an epithelial lesion; however, the histological examination revealed a colonic submucosal lipoma with overlying hyperplastic epithelium.
文摘A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas were identified. On endoscopy, multiple hyperplastic polyps were seen in the rectum and left-side colon. There were also esophageal glycogenic acanthosis and hyperplastic polyposis in the antrum accompanied by Helicobacter pylorirelated gastritis. Although gastric hyperplastic polyposis had by no means regressed with unsuccessful first-line eradication therapy for H pylori, following cure of the infection with salvage therapy consisting of rabeprazole,amoxicillin and metronidazole, the polyposis lesions almost disappeared. Follow-up gastroscopy 2 and 3 years after cessation of the second-line eradication therapy revealed almost complete regression of the polyposis lesions with no evidence of H pylori infection. We recommend eradication treatment for CD patients with gastric hyperplastic polyps and the infection, as the occurrence of gastric carcinoma among hyperplastic polyps has been described.
文摘Acalculous gallbladder diseases do not draw too much attention from researchers because of their low incidence of malignancy, no symptoms, and good prognosis, and therefore there is even no unanimous terminology. Emerged
文摘AIM： To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophagogastric junction （EGJ） associated with Barrett＇s esophagus （BE） with low-grade dysplasia （LGD）, by endoscopic rnucosal resection （EMR）. METHODS： Cap fitted EMR （EMR-C） was performed in 3 patients with hyperplastic-inflammatory polyps （HIPs） and BE. RESULTS： The polyps were successfully removed in the 3 patients. In two patients, with short segment BE （SSBE） （≤ 3 cm）, the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm × 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous reepithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR. CONCLUSION： EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.
基金National Natural Science Foundation of ChinaContract grant numbers:81271620,61275006,81101209+1 种基金Program for Changjiang Scholars and Innovative Research Teamin UniversityContract grant number:IRT1115.
文摘Precisely distinguishing between hyperplastic and adenomatous polyps and normal human colonic mucosa at the cellular level is of great medical significance.In this work,multiphoton laserscarming microscopy(MPLSM)was used to obtain the high.-contrast images and the morpho-logical characteristics from normal colonic mucosa,hyperplastic polyps and tubular adenoma.Byintegrating the length and area measurement tools and computing tool,we quantified thedifference of crypt morphology and the alteration of nuclei in normal and diseased human colonicmucosa.Our results demonstrated that the morphology of crypts had an obvious tendency tocystic dilatation or elongated in hyperplastic polyps and tubular adenoma.The cont ent andnumber of mucin droplets of the scattered goblet cells had a piecemeal reduction in hyperplastic polyps and a large decrease in tubular adenoma The nuclei of epithelial cells might be elongated and pseudostratified,but overt dysplasia was absent in hyperplastic polyps.Nevertheless,thenuclei showed enlarged,crowded,stratified and a rod-like structure,with loss of polarity intubular adenoma.These results suggest that MPLSM has the capacity to distinguish betweenhyperplastic and adenomat ous polyps and normal human colonic mucosa at the celular level.
文摘With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.
基金Supported by the Shaanxi Province Traditional Chinese Medicine Research and Innovation Talent Plan Project,No.TZKN-CXRC-16Project of Shaanxi Administration of Traditional Chinese Medicine,No.SZYKJCYC-2025-JC-010+2 种基金Shaanxi Province Outstanding TCM Talents Training Project Training Object in 2025Xi’an Science and Technology Plan Project,No.23YXYJ0162Shaanxi Province Key Research and Development Plan Project-Social Development Field,No.S2025-YF-YBSF-0391.
文摘BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high malignant potential,HPs have a low risk of potential harm,whereas sporadic FGPs have no malignant potential.It is not enough to determine the type and displacement of a polyp by biopsy alone;therefore,some polyps may require an extensive biopsy or complete resection.AIM To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.METHODS This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.RESULTS In a series of 10000 patients who underwent upper gastrointestinal endoscopy,384(3.84%)had GPs.There were 98 males(25.5%)and 286 females(74.5%).The mean age of patients was 62.8±10.4(36-75)years.The frequencies of HPs,APs,and FGPs were 88.5%,5.2%,and 2.1%,respectively.The polyp size of 274 patients(71.3%)was≤1 cm.Polyps were found in 262 cases(68.2%).The most common sites for polyps were the lumen and body of the intestine.Endoscopic polypectomy was performed in 128 patients.Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.CONCLUSION The incidence of GPs was low.HPs were the most common types of GPs.Of note,as GPs have the potential to develop into adenocarcinoma or precancerous lesions,we suggest that appropriate GP resection technology(e.g.,biopsy forceps or mesenchymal resection)be applied.
文摘In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and their prevalence remains unclear.Most GBPs in children are benign,and although the risk of malignancy is influenced by polyp size,growth rate,and morphology,specific criteria for the pediatric population are lacking.Management,therefore,is based on adult guidelines,with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation,while surveillance is applied to asymptomatic patients with smaller polyps.Further research is needed to develop pediatric-specific guidelines for the management of GBPs.This review discusses the classification,diagnosis,risk factors,and management of pediatric GBPs.
基金The authors would like to thank Professor Fatima Carneiro(Head of Department of Anatomic Pathology,University Hospital of S.Joao,Porto,Portugal)for histopathological consultation.
文摘This paper reports a rare case of early adenocarcinoma within the gastric hyperplastic polyp,that was completely resected during an endoscopic procedure,and discusses current recommendations in such cases.Endoscopic resection of polyps with focal dysplasia or cancer is commonly indicated,as long as the procedure can be performed safely.After complete excision of a polyp with atypical focal lesion,endoscopic surveillance is suggested.The frequency of surveillance endoscopy should depend on the precise histopathological diagnosis and possibility of confirming the completeness of the endoscopic resection.If the completeness of the procedure is confirmed both macro-and microscopically,gastric resection does not have to be performed.A follow-up esophago-gastroduodenoscopy should be performed at 1 year and then at 3 years.
文摘To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cases of AHN were investigated by PDS an d the findings were campared with those of digital subtraction angiography (DSA) Results The rates of arterial and portal flow in an afferent tumor vessel were 86 4% a n d 40 9% in SHCCs, respectively The rate of portal flow in an afferent tumor v essel was 60 0% in AHNs, while no arterial flow was detected ( P <0 01) In addition, PDS revealed a constant flow in an efferent tumor vessel (50 0%) c ontinuing to a portal branch in 10 (45 5%) of the 22 SHCCs cases to a hepatic v ein in 1 (4 5%) of the 22 SHCCs, but to nothing else in the AHNs ( P <0 01) Conclusions Power Doppler sonography is of value in distinguishing SHCC from AHN, and arteri al afferent tumor vessels from constant flow efferent tumor vessels at PDS
