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Korean J Gastroenterol  <  Volume 74(1); 2019 <  Articles

Korean J Gastroenterol 2019; 74(1): 17-29  https://doi.org/10.4166/kjg.2019.74.1.17
Risk Factors of Multiple Gastric Polyps according to the Histologic Classification: Prospective Observational Cohort Study
Chan Young Jeong1, Nayoung Kim1 , Hye Seung Lee2, Hyuk Yoon1, Cheol Min Shin1, Young Soo Park1, Jin-Wook Kim1 and Dong Ho Lee1,3
Departments of Internal Medicine1 and Pathology2, Seoul National University Bundang Hospital, Seoungnam; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine3, Seoul, Korea
Correspondence to: Nayoung Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: +82-31-787-7008, Fax: +82-31-787-4051, E-mail: nayoungkim49@empas.com, ORCID: https://orcid.org/0000-0002-9397-0406

Financial support: This work was supported by a grant from the National Research Foundation (NRF) of Korea to the Global Core Research Center (GCRC) funded by the Korean government (MSIP) (No. 2011-0030001).
Received: February 22, 2019; Revised: June 6, 2019; Accepted: June 7, 2019; Published online: July 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: The aim of this study was to determine the risk factors of multiple gastric polyps according to the histological classification of gastric polyps.
Methods: Subjects with multiple gastric polyps (at least three) during endoscopy were enrolled prospectively. They were assigned to a fundic gland polyp (FGP) group and hyperplastic polyp (HP) group based on a histological classification of gastric polyps. Helicobacter pylori (H. pylori) was confirmed by its histology. Serum gastrin was measured using the radioimmunoassay method. A questionnaire was taken regarding the intake of proton pump inhibitor and nonsteroidal anti-inflammatory drugs, alcohol, smoking history, and diet.
Results: Among the 60 subjects enrolled from 2015 to 2018 at Seoul National University Bungdang Hospital, 47 and 13 subjects were assigned to the FGP and HP groups, respectively. The H. pylori infection rate was 12.8% in the FGP group, which is lower than that in the HP group (69.2%, p<0.001). The gastrin level was higher in the HP group (194.7 pg/dL, range 50.6-387.8 pg/dL) than in the FGP group (57.4 pg/dL, range 24.8-79.0 pg/dL) (p=0.007). Histologically, neutrophil infiltration in the antrum and body of the stomach were higher in the HP group than in the FGP group (p=0.022 and p=0.030, respectively). In contrast, monocyte infiltration in the antrum and body of the stomach were higher in the FGP group than in the HP group (p=0.018 and p<0.001, respectively).
Conclusions: HPs arise from inflammation caused by H. pylori. On the other hand, the FGP was not associated with H. pylori or environmental factors.
Keywords: Gastric polyps; Helicobacter pylori; Proton pump inhibitors; Gastrin


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