Polypectomy rate and characteristics of polyps in upper gastrointestinal system endoscopy

BACKGROUND Upper gastrointestinal system (UGIS) polyps are detected infrequently during esophagogastroduodenoscopy (EGD). Data on the prevalence, characteristics, and dysplasia risk of these lesions remain limited compared with colorectal polyps. AIM To determine the detection rate of UGIS polyps in our center and to evaluate their clinical, endoscopic, and histopathological features. METHODS The medical records of 2095 patients who underwent EGD between January 2022 and January 2024 were retrospectively reviewed. A total of 110 patients (5.3%) with endoscopically detected polyps who underwent polypectomy were included. Demographic, clinical, endoscopic and histopathologic features were analyzed. RESULTS The median age was 65 years (range: 33-86), and 64.5% were female. Hyperplastic polyps were the most common type (70.9%). Dysplasia was identified in 5 patients (4.5%), all of whom had adenomatous or hyperplastic polyps. Dysplastic polyps were significantly larger than non-dysplastic polyps (median 10 mm vs 5 mm, P < 0.001) and were more frequently associated with intestinal metaplasia (P < 0.001) and Helicobacter pylori (H. pylori ) infection (P = 0.014). Receiver operating characteristic analysis revealed that polyp size strongly predicted the presence of dysplasia (area under the curve: 0.947; 95%CI: 0.891-1.000; P < 0.001), with an optimal cut-off value of 7.5 mm (sensitivity 100%, specificity 82.9%). CONCLUSION In our cohort, UGIS polyps were detected in approximately 5% of EGDs, and most were benign. Polyp size, H. pylori infection, and intestinal metaplasia were significantly associated with dysplasia. Given the malignant potential of adenomatous polyps and the size-dependent risk of dysplasia, complete endoscopic removal of incidentally detected UGIS polyps is advisable.