Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
Gastrointest Endosc. 2012 Mar;75(3):515-20. doi: 10.1016/j.gie.2011.08.021. Epub 2011 Oct 21.
Proximal colon serrated polyps likely contribute to the decreased protection of colonoscopy against right-sided colorectal cancer.
To estimate the prevalence and extrapolated detection rate of proximal serrated polyps at screening colonoscopy.
Retrospective study.
The study involved secondary analyses that used two databases. The first includes screening colonoscopies performed by 15 attending gastroenterologists at two academic endoscopy units between 2000 and 2009. The second includes average-risk patients who had previously participated in a randomized trial comparing high-definition chromocolonoscopy and white-light colonoscopy.
Prevalence of proximal serrated polyps found by the highest-level detectors and proximal serrated polyp detection rates corresponding to adenoma detection rates of 25% in men and 15% in women, respectively.
We analyzed 6681 procedures from the first database. Mean (± standard deviation) detection rates for adenomas and proximal serrated polyps were 38% ± 7.8% (range 17%-47%) and 13% ± 4.8% (1%-18%), respectively. There was a significant correlation between detection rates for adenomas and proximal serrated polyps for men (R = 0.71; P = .003) and women (R = 0.73; P = .002). Adenoma detection rates of 25% for men and 15% for women both corresponded to a detection rate of 4.5% for proximal serrated polyps. The prevalence of proximal serrated polyps found by the highest-level detector was 18%. The corresponding rate derived from the high-definition screening colonoscopy database was 20%.
Retrospective study.
The prevalence of proximal colon serrated polyps in average-risk patients undergoing screening colonoscopy is higher than previously reported. An extrapolated proximal serrated polyp detection rate of 5% is suggested for average-risk men and women.
近端结肠锯齿状息肉可能会降低结肠镜检查对右侧结直肠癌的保护作用。
估计筛查结肠镜检查中近端锯齿状息肉的患病率和推断检出率。
回顾性研究。
本研究涉及两项数据库的二次分析。第一项数据库包括 2000 年至 2009 年间在两个学术内镜单位由 15 名主治胃肠病学家进行的筛查结肠镜检查。第二项数据库包括先前参加过比较高清染色结肠镜检查与白光结肠镜检查的随机试验的平均风险患者。
最高级别的检测者发现近端锯齿状息肉的患病率以及与男性腺瘤检出率 25%和女性腺瘤检出率 15%分别对应的近端锯齿状息肉检出率。
我们分析了第一项数据库中的 6681 例操作。男性和女性的腺瘤和近端锯齿状息肉的平均（±标准差）检出率分别为 38%±7.8%（范围 17%至 47%）和 13%±4.8%（1%至 18%）。男性（R=0.71；P=0.003）和女性（R=0.73；P=0.002）的腺瘤检出率与近端锯齿状息肉检出率之间存在显著相关性。男性腺瘤检出率为 25%，女性腺瘤检出率为 15%，这两种情况均对应近端锯齿状息肉检出率为 4.5%。最高级别的检测者发现近端锯齿状息肉的患病率为 18%。源自高清筛查结肠镜数据库的相应检出率为 20%。
回顾性研究。
在接受筛查结肠镜检查的平均风险患者中，近端结肠锯齿状息肉的患病率高于先前报道的水平。建议平均风险男性和女性的近端锯齿状息肉的推断检出率为 5%。
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