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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Subtype-specific risk factors for gastric adenomas and independent predictors of recurrence after endoscopic resection
Nada El-Domiaty, Frédéric Beuvon, Marine Carpentier-Pourquier, Wafaa Ibrahim, Sarra Oumrani, Paul Doumbe-Mandengue, Arthur Belle, Stanislas Chaussade, Anna Pellat, Gamal Shiha, Romain Coriat, Maximilien Barret
Nada El-Domiaty, Marine Carpentier-Pourquier, Sarra Oumrani, Paul Doumbe-Mandengue, Arthur Belle, Stanislas Chaussade, Anna Pellat, Romain Coriat, Maximilien Barret, Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris 94800, Île-de-France, France
Nada El-Domiaty, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 12547, Egypt
Frédéric Beuvon, Department of Pathology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris 94800, Île-de-France, France
Frédéric Beuvon, Paul Doumbe-Mandengue, Stanislas Chaussade, Anna Pellat, Romain Coriat, Maximilien Barret, Paris University, Paris 94800, Île-de-France, France
Wafaa Ibrahim, Department of Statistics, Faculty of Economics and Political Science, Cairo University, Cairo 12613, Egypt
Gamal Shiha, Department of Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura 11001, Egypt
Author contributions: El-Domiaty N participated in research design; acquisition of the data; analysis and interpretation of the data; drafting of the manuscript; critical revision of the manuscript; and statistical analysis; Ibrahim W participated in the statistical analysis and interpretation of the data; Barret M participated in the research design; analysis and interpretation of the data; drafting of the manuscript; and critical revision of the manuscript; Beuvon F participated in the acquisition, analysis and interpretation of the histopathological data; Carpentier-Pourquier M, Oumrani S, Doumbe-Mandengue P, Belle A, Shiha G, Chaussade S, Coriat R and Pellat A participated in critical revision and approval of the manuscript.
Institutional review board statement: The study was reviewed and approved by the local Cochin Hospital Ethics Committee (reference number: AAA-2023-09011).
Informed consent statement: All the patients aware that their data could be used for some research as this is a university hospital.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Data sharing statement: No additional data is available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Nada El-Domiaty, Department of Endemic Medicine, Faculty of Medi
cine, Helwan University, Al Sikka Al Hadid Al Gharbeya, Qism Helwan, Cairo 12547, Egypt.
nada.eldomiaty@med.helwan.edu.eg
Received: June 7, 2025
Revised: July 27, 2025
Accepted: October 10, 2025
Published online: November 16, 2025
Processing time: 161 Days and 7.8 Hours
BACKGROUND
Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma. The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.
AIM
To assess the subtype-specific risk factors and outcomes of endoscopic resection (ER) for gastric adenomas.
METHODS
This is a retrospective cohort study. Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022, 79 patients with gastric adenomas were included. Hyperplastic polyps (n = 37) and subepithelial lesions (n = 46) were excluded. Logistic regression and survival analyses were conducted.
RESULTS
The 79 patients (mean age 68.1 years; 65% male) had adenoma subtypes: 62% intestinal, 29% foveolar, 8% pyloric, and 1% oxyntic. The mean follow-up was 26 months. Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis (P < 0.001); foveolar adenoma was significantly associated with intestinal metaplasia (P < 0.001). Pyloric adenomas had the largest polyp size (P < 0.001). Recurrence rates were 8%, 17%, and 17% for the respective subtypes (P = 0.07), with no significant difference in the meantime to recurrence (P = 0.8). Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma, active Helicobacter pylori infection, polyp size ≥ 30 mm, presence of > 3 polyps and Paris 0-IIc morphology (P < 0.001).
CONCLUSION
This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER, underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.
Core Tip: Gastric adenomas exhibit subtype-specific characteristics; intestinal adenomas linked to family history of gastric adenocarcinoma and atrophic gastritis, foveolar adenomas associated with nonsteroidal anti-inflammatory drug use and intestinal metaplasia, and pyloric adenomas presenting as large multiple polyps. Understanding the unique clinicopathological features of different subtypes of gastric adenomas helps to implement risk-stratified surveillance strategies and address modifiable factors like Helicobacter pylori infection to reduce recurrence rates.
