Clinicopathological characteristics of gastric polyps and predictors of high-risk pathology: A single-center study from the van region

INTRODUCTION: Gastric polyps are frequently detected during upper gastrointestinal endoscopy, most of which are benign; however, a subset carries a risk of malignant transformation. Identifying factors associated with high-risk gastric pathology remains clinically important, particularly in regions with distinct epidemiological characteristics. This study aimed to evaluate the clinicopathological features of gastric polyps and to identify predictors of high-risk pathology in patients undergoing gastric polypectomy in the Van region of eastern Türkiye.
METHODS: This retrospective, single-center study included 210 consecutive patients who underwent endoscopic gastric polypectomy. Demographic data, endoscopic findings, and histopathological results were analyzed. High-risk pathology was defined as adenomatous polyps, high-grade dysplasia, or neuroendocrine tumors. Group comparisons, receiver operating characteristic (ROC) analysis, and penalized multivariable logistic regression were performed.
RESULTS: High-risk gastric pathology was identified in 9 patients (4.3%). Patients with high-risk lesions had a significantly higher polyp count and were more likely to have multiple polyps and underlying atrophic gastritis. Polyp size demonstrated limited discriminative ability for high-risk pathology (AUC=0.603). In exploratory penalized multivariable analysis, male sex, polyp multiplicity, and atrophic gastritis were associated with increased odds of high-risk pathology.
DISCUSSION AND CONCLUSION: High-risk gastric polyps were uncommon in this regional cohort. Polyp multiplicity and atrophic gastritis, rather than polyp size alone, were the main factors associated with high-risk pathology. Comprehensive assessment of both endoscopic features and background gastric mucosa may improve risk stratification in patients with gastric polyps.

Keywords: Duodenoscopy, gastric mucosa, gastritis, gastroscopy, polyps