Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Gastroenterology. 2010 Nov;139(5):1503-10, 1510.e1-3. doi: 10.1053/j.gastro.2010.07.011. Epub 2010 Jul 16.
BACKGROUND & AIMS: There is evidence that serrated polyps (serrated adenomas and hyperplastic polyps) have different malignant potential than traditional adenomas. We used a colonoscopy database to determine the association between the presence of serrated colorectal polyps and colorectal neoplasia.
We performed a multicenter observational study of 10,199 subjects who underwent first-time colonoscopies. Data collected on study subjects included age and sex and the location, size, and histology of polyps or tumors found at colonoscopy. Serrated polyps were defined as those diagnosed by the pathologists in the participating hospitals as a serrated lesion (a lesion given the term of "classical hyperplastic polyp," "traditional serrated adenoma," "sessile serrated adenoma," or "mixed serrated polyp"). Large serrated polyps (LSPs) were defined as those ≥ 10 mm.
There were 1573 patients (15.4%) with advanced neoplasia, 708 patients (6.9%) with colorectal cancer (CRC), and 140 patients (1.4%) with LSPs in our cohort. Multivariate analysis associated the presence of LSPs with advanced neoplasia (odds ratio [OR], 4.01; 95% confidence interval [CI], 2.83-5.69) and CRC (OR, 3.34; 95% CI, 2.16-5.03). The presence of LSPs was the greatest risk factor for CRC, particularly for proximal CRC (OR, 4.79; 95% CI, 2.54-8.42). Proximal and protruded LSPs were the highest risk factors for proximal CRC (OR, 5.36; 95% CI, 2.40-10.8 and OR, 9.00; 95% CI, 2.75-19.2, respectively).
The presence of LSPs is a risk factor for CRC, particularly CRC of the proximal colon.
有证据表明锯齿状息肉（锯齿状腺瘤和增生性息肉）的恶性潜能与传统腺瘤不同。我们使用结肠镜数据库来确定锯齿状结直肠息肉的存在与结直肠肿瘤之间的关联。
我们对 10199 名首次接受结肠镜检查的患者进行了一项多中心观察性研究。研究对象的数据包括年龄和性别以及结肠镜检查中发现的息肉或肿瘤的位置、大小和组织学。锯齿状息肉是指参与医院的病理学家诊断为锯齿状病变（病变被命名为“经典增生性息肉”、“传统锯齿状腺瘤”、“无蒂锯齿状腺瘤”或“混合锯齿状息肉”）。大锯齿状息肉（LSP）定义为≥10mm。
在我们的队列中，有 1573 名患者（15.4%）存在晚期肿瘤，708 名患者（6.9%）患有结直肠癌（CRC），140 名患者（1.4%）患有 LSP。多变量分析将 LSP 的存在与晚期肿瘤（比值比[OR]，4.01；95%置信区间[CI]，2.83-5.69）和 CRC（OR，3.34；95% CI，2.16-5.03）相关联。LSP 的存在是 CRC 的最大危险因素，特别是对于近端 CRC（OR，4.79；95% CI，2.54-8.42）。近端和突出的 LSP 是近端 CRC 的最高危险因素（OR，5.36；95% CI，2.40-10.8 和 OR，9.00；95% CI，2.75-19.2）。
LSP 的存在是 CRC 的危险因素，特别是近端结肠癌。
