Department of Gastroenterology, Complejo Hospitalario de Navarra B, Pamplona, Spain.
Eur J Gastroenterol Hepatol. 2013 Jan;25(1):28-32. doi: 10.1097/MEG.0b013e3283598506.
Serrated polyposis (SP) is an infrequent colorectal cancer (CRC) predisposition syndrome. An unidentified genetic defect is believed to play a role in this condition. The risk of SP and/or CRC for first-degree relatives (FDRs) is not yet well known. The aim of our study was to determine the incidence of both SP and/or CRC by studying the FDRs of our index SP cases and to propose an appropriate interval for colonoscopy surveillance in this group.
From 2005 to December 2011, we prospectively included all patients from our hospital who fulfilled the SP diagnostic criteria. We interviewed FDRs face to face and offered a colonoscopy to those who were 35 years old or older. The study was carried out with conventional and high-definition colonoscopes and chromoendoscopy with indigo carmine at the discretion of a single endoscopist. The samples were assessed by two pathologists. We reviewed the clinical data for CRC diagnosed previously in FDRs.
From 2005, we collected all the new cases of SP and offered a colonoscopy to 95 FDRs of 34 pedigrees. We performed colonoscopies on 78 FDRs (82.1%). The incidence of SP in the FDRs was 32% (25 patients). Seventy-six percent of patients were diagnosed with SP as they had any number of serrated polyps proximal to the sigmoid colon. Only one patient was diagnosed with CRC as a result of the screening colonoscopy. 44.1% of our index cases had an FDR with a diagnosis of CRC.
Our series, which is the largest prospective cohort of FDRs published, reports an elevated incidence of SP in FDRs, thus supporting the need for screening colonoscopy in FDR and its inclusion in the guidelines.
锯齿状息肉病（SP）是一种罕见的结直肠癌（CRC）易患综合征。据信，一种未识别的遗传缺陷在这种情况下发挥作用。一级亲属（FDR）的 SP 和/或 CRC 风险尚不清楚。我们研究的目的是通过研究我们的 SP 指数病例的 FDR，确定两者的发生率，并为该组提出适当的结肠镜监测间隔。
从 2005 年至 2011 年 12 月，我们前瞻性地纳入了符合 SP 诊断标准的所有我院患者。我们与 FDR 面对面访谈，并为 35 岁或以上的 FDR 提供结肠镜检查。该研究使用常规和高清结肠镜以及靛胭脂 chromoendoscopy 进行，由一名内镜医生酌情进行。样本由两名病理学家进行评估。我们回顾了 FDR 中以前诊断出的 CRC 的临床数据。
从 2005 年起，我们收集了所有新的 SP 病例，并为 34 个谱系的 95 名 FDR 提供了结肠镜检查。我们对 78 名 FDR（82.1%）进行了结肠镜检查。FDR 中 SP 的发生率为 32%（25 名患者）。76%的患者因结肠镜检查诊断为 SP，因为他们在乙状结肠近端有任何数量的锯齿状息肉。只有一名患者因筛查结肠镜检查而被诊断为 CRC。我们的 44.1%的指数病例有一个 FDR 被诊断为 CRC。
我们的系列研究是发表的最大的 FDR 前瞻性队列研究，报告了 FDR 中 SP 的发病率升高，因此支持对 FDR 进行筛查性结肠镜检查，并将其纳入指南。
