Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 20; no. 2; pp. 314 - 321
• Main Authors: Takeuchi, Chihiro, Yamamichi, Nobutake, Shimamoto, Takeshi, Takahashi, Yu, Mitsushima, Toru, Koike, Kazuhiko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.03.2017; Springer Nature B.V
• Subjects: Abdominal Surgery; Adenomatous Polyps - diagnosis; Adenomatous Polyps - diagnostic imaging; Adenomatous Polyps - microbiology; Adult; Aged; Barium - metabolism; Cancer Research; Female; Follow-Up Studies; Gastric cancer; Gastric Mucosa - diagnostic imaging; Gastric Mucosa - microbiology; Gastric Mucosa - pathology; Gastroenterology; Gastrointestinal Tract - diagnostic imaging; Helicobacter; Helicobacter Infections - complications; Helicobacter Infections - diagnostic imaging; Helicobacter Infections - microbiology; Helicobacter pylori - pathogenicity; Humans; Hyperplasia - diagnosis; Hyperplasia - diagnostic imaging; Hyperplasia - microbiology; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Original Article; Prognosis; Prospective Studies; Radiography, Abdominal - methods; Stomach Neoplasms - diagnosis; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - drug therapy; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Surgical Oncology; X-Rays; Gastric polyp; Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR); Gastric cancer; Upper gastrointestinal endoscopy (UGI-ES); Helicobacter pylori
• ISSN: 1436-3291; 1436-3305
• DOI: 10.1007/s10120-016-0607-3

Background Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) is a method broadly used for gastric cancer screening in Japan. Gastric polyp is one of the most frequent findings detected by UGI-XR, but how to handle it remains controversial. Methods Gastric polyps of the 17,264 generally healthy subjects in Japan who underwent UGI-XR or upper gastrointestinal endoscopy (UGI-ES) in 2010 were analyzed. Results Of the 6,433 UGI-XR examinees (3,405 men and 3,028 women, 47.4 ± 9.0 years old), gastric polyps were detected in 464 men (13.6 %) and 733 women (24.2 %) and were predominantly developed on the non-atrophic gastric mucosa ( p  < 0.0001). Multiple logistic regression analysis showed that the presence of gastric polyps has significant association with lower value of serum anti- Helicobacter pylori IgG titer, female gender, lighter smoking habit, older age, and normal range of body mass index ( ≥ 18.5 and <25), but not with drinking or serum pepsinogen I/II ratio. During the 3-year follow-up, gastric cancer occurred in 7 subjects (0.11 %), but none of them had gastric polyps at the beginning of the follow-up period. Of the 2,722 subjects with gastric polyps among the 10,831 UGI-ES examinees in the same period, 2,446 (89.9 %) had fundic, 267 (9.8 %) had hyperplastic, and 9 (0.3 %) had adenomatous/cancerous polyps. Conclusions Gastric polyps diagnosed by UGI-XR predominantly arise on the Helicobacter pylori -negative gastric mucosa with a low risk of gastric cancer in Japan. In the prospective observation, none of the UGI-XR examinees with gastric polyps developed gastric cancer for at least 3 years subsequently.