The influence of HP infection and duodenogastric reflux on the development and results of treatment of certain morphological types of gastric polyps

• Myasnyankina G.N.
• Samgina T.A.

Abstract

Аim – to analyze the effect of HP infection and duodenogastric reflux on the development and results of treatment of certain morphological types of gastric polyps.

Material and methods. In the period from 2018 to 2023 patients with gastric polyps underwent 418 fibrogastroduodenoscopies; biopsy forceps were used to take biopsies from the polyp (4–5) and 2–4 from the antrum, body and vault of the stomach to determine the degree of Helicobacter pylori contamination and assess the impact of duodenogastric reflux. Histological material was stained with hematoxylin and eosin and Romanovsky–Giemsa. 141 patients underwent endoscopic polypectomy. The results of treatment and the condition of the gastric mucosa were assessed over a period of 6 to 12 months. All patients signed informed consent to participate in the study, approved by the Regional Committee of KSMU. Statistical data processing was carried out using the Statistica 10.0 program.

Results. Most often we encountered single (p=0.03) hyperplastic polyps of the antrum of the stomach (p=0.03), ranging in size from 1–4 mm (p=0.03), type Is (80.6%). The morphological analysis established the following histological types of polyps: hyperplastic – 352 (84.2%), adenomatous – 40 (9.6%) and fundic gland polyps – 26 (6.2%). The coefficients of HP contamination were 0.9 for adenomatous polyps, 0.8 for hyperplastic polyps, and 0.5 for fundic gland polyps. Moreover, in the presence of duodenogastric reflux, the bacteria took a coccal form, which is associated with the influence of an unfavorable factor for them; duodenogastric reflux played a sanitizing role in relation to HP infection. We did not find any recurrence of polyp formation at the site of its removal, however, in 11 (7.8%) patients, developing hyperplastic single polyps of the antrum were diagnosed; the morphological picture was preserved; the patients did not follow the gastroenterologist’s instructions.

Conclusion. Polyps form on altered mucosa, which is confirmed by the high frequency of detection of concomitant pathology. When choosing diagnostic and treatment tactics for patients with gastric polyps, treatment should be coordinated with a gastroenterologist and drug correction of underlying diseases should be carried out, since both the result of endoscopic polypectomy and the course of the disease as a whole depend on this.

Keywords:stomach polyps; HP infection; duodenogastric reflux

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