Department of Pathology, The University of Chicago Medical Center, Chicago, IL, USA.
Histopathology. 2010 Apr;56(5):581-8. doi: 10.1111/j.1365-2559.2010.03520.x.
To determine the prevalence of various colonic polyps removed during a recent 8-month period; to determine the interobserver agreement in the diagnosis of serrated polyps; and to determine if harbouring a sessile serrated adenoma (SSA) predisposes to the presence of synchronous polyps with similar histology.
All polyps resected during an 8-month period at a single tertiary medical centre were analysed. We also analysed all polyps in patients with an SSA or SSA with dysplasia since 2003. SSAs accounted for 4.3% of colonic polyps removed during an 8-month period. A review of 276 serrated polyps by two pathologists revealed good interobserver agreement (kappa = 0.66). Patients with one SSA were more likely to harbour additional serrated polyps. After removal of the index SSA, 18% of their remaining polyps were SSAs, SSAs with dysplasia, and traditional serrated adenomas, contrasting with the approximately 5% prevalence of these polyps in the control population. The hyperplastic polyps in the study population were also twice as likely to occur proximal to the splenic flexure.
These data indicate that there is a strong colonic mucosal field defect in patients with sporadic SSAs that predispose them to develop additional serrated polyps.
确定在最近 8 个月期间切除的各种结肠息肉的患病率；确定锯齿状息肉诊断的观察者间一致性；并确定是否存在无蒂锯齿状腺瘤 (SSA) 是否会导致具有相似组织学的同步息肉的存在。
分析了在单一三级医疗中心的 8 个月期间切除的所有息肉。我们还分析了自 2003 年以来患有 SSA 或 SSA 伴异型增生的所有患者的息肉。SSA 占 8 个月期间切除的结肠息肉的 4.3%。两名病理学家对 276 个锯齿状息肉的回顾显示出良好的观察者间一致性（kappa = 0.66）。患有一个 SSA 的患者更有可能藏匿其他锯齿状息肉。在切除索引 SSA 后，其剩余息肉中有 18%为 SSA、伴有异型增生的 SSA 和传统锯齿状腺瘤，与对照组中这些息肉的约 5%患病率形成对比。研究人群中的增生性息肉也更有可能发生在脾曲附近。
这些数据表明，散发性 SSA 患者的结肠黏膜存在强烈的黏膜缺陷，使他们更容易发生其他锯齿状息肉。
