Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 105136
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.105136
Comparison of endoscopic ultrasonography features and pathological staging of gastric inflammatory fibroid polyps
Fen-Ming Zhang, Long-Gui Ning, Xiao-Xi Wang, Hao-Jie Du, Hua-Tuo Zhu, Hong-Tan Chen
Fen-Ming Zhang, Long-Gui Ning, Hao-Jie Du, Hua-Tuo Zhu, Hong-Tan Chen, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Xiao-Xi Wang, Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Chen HT designed the research and revised the paper; Zhang FM and Du HJ conducted the research; Ning LG and Zhu HT analyzed the data or performed statistical analysis; Zhang FM drafted the paper; Wang XX performed pathological analysis; All authors have read and approved the final version of the manuscript.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University on August 16, 2023 (No. 0634).
Informed consent statement: Patients were not required to give informed consent to the study because the study was retrospective.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: No additional data are 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: Hong-Tan Chen, MD, Doctor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. chenhongtan@zju.edu.cn
Received: January 15, 2025
Revised: March 16, 2025
Accepted: May 19, 2025
Published online: July 27, 2025
Processing time: 189 Days and 21.9 Hours
Abstract
BACKGROUND

The diagnosis of gastric inflammatory fibroid polyps (IFPs) mainly depends on pathological confirmation after endoscopic or surgical treatment. Gastric IFP have typical manifestations under endoscopic ultrasonography (EUS), but atypical EUS features have also been reported. Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations. At present, there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages. We hypothesize that gastric IFPs at different pathological stages may have different EUS features.

AIM

To describe EUS features of gastric IFPs and compare with their pathological characteristics.

METHODS

Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected. All patients underwent preoperative EUS. We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.

RESULTS

Most gastric IFPs showed medium-low echo (67.9%), homogeneous echo (90.6%), and unclear boundaries (83%), and involved the second and third layers of the gastric wall (69.8%) under EUS. The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP. Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo. Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo. Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity. The accuracy of EUS in diagnosing gastric IFPs was 66.0% (35/53), and the accuracy in determining the origin layer of gastric IFPs was 73.4% (39/53).

CONCLUSION

Gastric IFPs at different pathological stages have different EUS features. In order to improve the diagnostic rate, it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.

Keywords: Gastric inflammatory fibroid polyps; Endoscopic ultrasonography; Nodular stage; Fibrovascular stage; Sclerotic stage

Core Tip: This is believed to be the first study analyzing the endoscopic ultrasonographic (EUS) manifestations of gastric inflammatory fibroid polyps (IFPs) at different pathological stages. It was found that echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFPs. Nodular stage gastric IFPs presented hypoechoic and homogeneous echo. Fibrovascular stage gastric IFPs mostly showed medium-low echo and homogeneous echo. Sclerotic stage showed different echogenicity levels and echo homogeneity. The accuracy of EUS in diagnosing gastric IFPs was 66.0%, and the accuracy in determining the origin layer of gastric IFPs was 73.4%.