The present study is aimed to evaluate the relationship be tween the histologic type
and malignant potential of gastrointestinal polyps. The material consists of polyps
obtained from 256 patients and examined at the Department of Pathology, Yonsei
University College of Medicine from January, 1968 through December, 1982. After the
classification of polyps by the histologic type, age and sex of the patients, size and
shape of polyps, size, clinical symptoms, and dysplastic change were reviewed. Special
stains such as periodic acid-Schiff, alcian blue pH 2.5 and 1.0, and Spicer's high iron
diamine method were applied for the demonstration of the amount and the character of
mucin.
Results obtained were as follows:
1) The cases consist of 46 gastric polyps and 211 colonic polyps. Terminal ileum was
involved by a case of familial multiple polyposis. The multiplicity rate was 4.84. The
hyperplastic polyp was the predominant histologic type among gastric polyps and the
retention polyp and the tubular adenoma among colonic polyp. Seven crises of familial
multiple polyposis and two cartes of Peutz-Jeghers syndrome were observed.
2) The overall male to female ratio was 1.39 : 1. The hyrerplastic polyp was
distributed evenly from the 3rd decade of life. The tubular adenoma was predominant in
the 5 th and 6 th decodes, the villous adenoma in older age than the tubular adenoma,
the retention polyp in the 1 st decade, and the familial multiple polyposis in the 4 th
decade.
3) The size of polyps was less than 1.5 cm in diameter in most of the hyperplastic
polyps. Otherwise the tubular and the villous adenomas had significant number of larger
size. The retention polyps were variable in their size.
4) By Yamada's criteria of gross type the hyperplastic polyp and the tubular adenoma
belonged to the type Ⅲ, the villous adenoma type Ⅰ, and the retention polyp type Ⅳ.
5) The large majority of gastric polyps arose in the antrum with the highest incidence
in hyperplastic polyps. The large majority of colonic polyps arose in the rectum and
sigmoid with the highest incidence in villous adenomas at rectum.
6) The patients with gastric polyps complained of epigastric pain or discomfort and the
patients with colonic polyps, rectal bleeding. The average duration was within 6 months.
7) Fifteen crises of polyps were associates with carcinoma, which consisted of 14
adenocarcinomas and 1 epidermoid carcinoma.
8) About 30% of gastric and colonic polyps showed dysplastic change. The histologic
types such as the tubular adenoma, villous adenoma, and familial multiple polyposis only
showed dysplasia, which is milder in tubular adenoma and more severe in villous
adenoma. Highest incidence of malignant change was associated with polyps of Yamada
type Ⅰ.
9) Special stains showed normal mucosal mucous pattern in the hyperplastic and
retention polyps. The number of goblet cells and the amount of mucus were slightly
decreased in the tubular and villous adenomas and markedly decreased in polyps with
dysplasia, i. e. ; gastric polyps showed decrease in neutral mucin and colonic polyps
decrease in sulfomucin. And these were directly related to the degree of dysplasia.
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