In gastroenterology clinics, we often see such a gastroscopy report: “gastric polyp”. When some patients see such a report, they think they have stomach cancer and are often anxious about it. What exactly is a gastric polyp? Is it possible to become cancerous? What is the treatment needed? We would like to summarize and answer the relevant questions for our readers. I. What is a gastric polyp? The name “polyp” usually only means the bulge observed by the naked eye, gastric polyp refers to the papillary protrusion on the surface of the gastric mucosa, mostly from the abnormal proliferation of the gastric mucosa. There are often no obvious symptoms when they are small, and they are usually found by chance during gastroscopy, barium meal gastrointestinal imaging or surgery for other reasons. Second, can gastric polyps become cancerous? Why do we need biopsy? Many people found polyps in the stomach, they often have such doubts: Is this disease of gastric polyp harmful? Will it become cancerous? In fact, there are usually two types of gastric polyps, one is called adenomatous polyps, which are composed of dense, crowded, hyperplastic gastric glands, with varying degrees of atypical hyperplasia, the cancer rate can be 30% to 58.3%, known as “precancerous lesions”; the other is called hyperplastic polyps, also known as inflammatory polyps or regenerative The other kind is called hyperplastic polyp, also called inflammatory polyp or regenerative polyp, which is a prolonged proliferation of gastric glands with disorderly arrangement, large gaps between glands and immature cells in the middle of some of them, and most of them have no atypical hyperplasia, and the cancer rate is only about 0.4%. The purpose of biopsy is to confirm through pathology that the polyps are adenomatous polyps or hyperplastic polyps, if they are adenomatous polyps, in principle, they need to be removed to eliminate future problems; if they are hyperplastic polyps, according to the etiology, take appropriate measures. Third, how are gastric polyps formed? At present, the etiology and pathogenesis of gastric polyps are still not completely clear, preliminary studies suggest that: hyperplastic polyps or inflammatory polyps are usually due to the adaptive response caused by infection and injury in the stomach, such as Helicobacter pylori (H. pylori, Hp) infection, in China, the infection rate of 57% to 75%, Hp-positive hyperplastic polyps patients after successful eradication of Hp infection, about 40% of them The relationship between adenomatous polyps and Hp infection is not clear, and its occurrence is mostly related to genetic mutations, which may be due to external or environmental factors that lead to multiple genetic changes and produce. Fourth, do gastric polyps need treatment? As mentioned before, hyperplastic polyps with Hp infection require Hp eradication; adenomatous polyps in principle require resection treatment (endoscopic treatment is preferred). 1.Endoscopic treatment Endoscopic resection is the preferred method for the treatment of gastric polyps, mainly including high frequency electrocoagulation resection method, microwave cauterization method, nylon wire ligation method, argon ion coagulation method, endoscopic mucosal resection (EMR), endoscopic mucosal dissection (ESD), etc., which has the characteristics of less trauma, fewer complications, faster postoperative recovery, no organ function damage, etc. If combined with painless gastroscopy technique at the same time, the treatment process is painless for patients. High-frequency electrocoagulation method is one of the most widely used methods, and its principle is to use the thermal effect generated by high-frequency current to cause tissue coagulation and necrosis to achieve the purpose of removing polyps. The microwave cautery method uses the principle of microwave heat effect to coagulate and vaporize the tissue for polyp removal, which also has the effect of hemostasis and is suitable for non-tipped polyps <2cm in diameter, which can be cauterized at once for smaller polyps, while larger ones require multiple treatments. The nylon wire and rubber band ligation method is used to ligate the root of polyps to make them ischemic and necrotic for treatment purpose. The polyps fall off and form shallow ulcers about 1 week after ligation, and eventually heal by forming a scar. Argon ion coagulation Argon gas can conduct high-frequency current through ionization to cause coagulation and necrosis of the tissue, which is mainly applied to polyps with wide base and no tip and diameter <1.5 cm. EMR is a technical method to excise large pieces of mucosal tissue after injecting drugs into the submucosal layer of the lesion (e.g., non-tipped polyps, flat or shallow depressed polyps) to form a liquid pad. The advantage is that the lesion can be removed endoscopically without open surgery, and the EMR technique increases the area and depth of lesion removal with minimal damage to the stomach for the purpose of radical treatment, which is largely replaced by the EMR method in patients who are traditionally considered [7, 8] to require open surgery (e.g., polyps >2 cm in diameter, polyps complicated by bleeding). ESD refers to the endoscopic peeling of the mucosa directly from the submucosa using a modified needle knife.ESD originally originated in Japan and is currently the most commonly used method for large lesion excision.ESD uses a common single-channel endoscope to perform whole lesion excision, which not only achieves whole lesion excision of large lesions, but also provides accurate pathological staging to prevent recurrence, even if the polyp is >3 cm in diameter or the polyp is Even if the polyp is >3cm in diameter or the polyp is cancerous but does not infiltrate into the submucosa, it can also be excised to avoid surgical operation. 2.Anti-Hp treatment Studies have shown that Hp infection is closely related to the occurrence of hyperplastic polyps, and after successful eradication of Hp infection in Hp-positive hyperplastic polyps, the polyps completely regressed in about 40% of patients. 3.Surgical treatment Indications for surgery are: polyps with cancerous lesions and infiltration to the submucosa.