胃ポリープの病理学的分類・鑑別診断と臨床的意義

Pathological Classification, Differential Diagnosis and Clinical Significance of Gastric Polyps

要旨　胃のポリープの頻度は0.6～3％程度と報告されている．非腫瘍性上皮性ポリープのうち最も頻度が高いのは過形成ポリープで，次いで胃底腺ポリープである．そのほかにまれなものでhamartomatous inverted polyp，特殊なもので内視鏡治療後のポリープや残胃吻合部のポリープなどがある．そのほとんどは良性であるが，一部は悪性化するものも存在する．それらの取り扱いを考慮するうえで，癌化の危険性や癌化例の特徴を含めた臨床病理学的特徴を把握しておくことが重要である．

　The frequency of polyps of the stomach has been reported to be about 0.6 to 3％. The most common non-neoplastic epithelial polyps are hyperplastic, and they are followed in by frequencyrate fundic gland polyps. In addition, the peculiar polyps hamartomatous inverted polyp and those found in special conditions such as regenerative polyps after endoscopic resection and stomal polypoid hypertrophic gastritis are also recognized, but they are rare.

　Although these polyps are usually benign, malignant transformation is occasionally seen. It is important for managing them clinically to know their characteristic clinicopathological features, including the risk of malignant transformation and the carcinogenetic pathway.