Clinicopathological Features of Biopsy-Proven Foveolar Hyperplasia in the Absence of Hypertrophic Gastropathy

Foveolar hyperplasia is a common histopathological finding in gastric biopsies; however, its clinical relevance remains unclear, particularly in the absence of overt hypertrophic gastropathy or Ménétrier’s disease. This retrospective study aimed to evaluate the clinical, laboratory, histopathological, and radiological characteristics of patients with foveolar hyperplasia detected in gastric corpus biopsies obtained from endoscopically normal or mildly edematous mucosa. Patients who underwent upper gastrointestinal endoscopy between 2022 and 2025 and had corpus biopsies were included. Those with histologically confirmed foveolar hyperplasia were compared with age- and sex-matched controls without foveolar hyperplasia. Clinical data, laboratory parameters, endoscopic findings, and computed tomography results were reviewed and analyzed. A total of 352 patients were included, comprising 178 patients with foveolar hyperplasia and 174 controls. Platelet counts were significantly higher in the foveolar hyperplasia group, whereas hemoglobin, C-reactive protein, ferritin, and albumin levels did not differ significantly between groups. Helicobacter pylori positivity and glandular atrophy were significantly less frequent in patients with foveolar hyperplasia. Multivariate logistic regression analysis identified higher platelet count and H. pylori negativity as independent factors associated with foveolar hyperplasia, although receiver operating characteristic analysis demonstrated limited diagnostic performance. These findings suggest that foveolar hyperplasia may be encountered incidentally in gastric biopsies without clinical or endoscopic evidence of hypertrophic gastropathy and does not appear to be associated with systemic inflammation or nutritional impairment. The clinical significance of its association with platelet elevation and H. pylori negativity remains uncertain.