Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
J Gastroenterol Hepatol. 2013 Nov;28(11):1693-8. doi: 10.1111/jgh.12307.
Hyperplastic/serrated polyposis syndrome (HPS) is a condition characterized by multiple hyperplastic/serrated colorectal polyps. The risk of colorectal cancer (CRC) is increased in HPS. The clinicopathologic characteristics of HPS in Japanese patients are unknown. The aim of this study is to clarify the clinicopathologic features of HPS in Japanese patients.
We retrieved records of patients diagnosed with HPS between April 2008 and March 2011 from the endoscopy database of Hiroshima University Hospital. In addition, we mailed a questionnaire to the hospital's 13 affiliated hospitals in July 2012. Data collected from the database and questionnaires included patient age, sex, number of hyperplastic/serrated polyps and tubular adenomas, size of the largest polyp, polyp location, resection for polyps, coexistence of HPS with CRC, and the diagnostic criterion met.
Of the 73,608 patients who underwent colonoscopy, 10 (0.014%) met the criteria for HPS. The mean age of these patients was 58.3 years, and 6 (60%) were men. No subjects had a first-degree relative with HPS. Four (40%) HPS patients had more than 30 hyperplastic/serrated polyps, and average size of the largest polyp was 19 mm. Three (30%) HPS patients had coexistence of HPS with CRC. In these 3 patients, polyps were observed throughout the colorectum.
Although HPS was a rare condition in the overall study population, patients with the disease may have high risk of CRC. HPS should be diagnosed correctly and followed up carefully.
增生/锯齿状息肉综合征(HPS)是一种以多发性增生/锯齿状结直肠息肉为特征的疾病。HPS 患者结直肠癌(CRC)的风险增加。日本患者 HPS 的临床病理特征尚不清楚。本研究旨在阐明日本患者 HPS 的临床病理特征。
我们从广岛大学医院的内窥镜数据库中检索了 2008 年 4 月至 2011 年 3 月期间诊断为 HPS 的患者记录。此外,我们于 2012 年 7 月向医院的 13 家附属医院邮寄了一份调查问卷。从数据库和调查问卷中收集的数据包括患者年龄、性别、增生/锯齿状息肉和管状腺瘤数量、最大息肉大小、息肉位置、息肉切除、HPS 与 CRC 共存以及符合的诊断标准。
在接受结肠镜检查的 73608 名患者中,有 10 名(0.014%)符合 HPS 的标准。这些患者的平均年龄为 58.3 岁,6 名(60%)为男性。无 HPS 一级亲属。4 名(40%)HPS 患者有超过 30 个增生/锯齿状息肉,最大息肉的平均大小为 19mm。3 名(30%)HPS 患者同时患有 HPS 和 CRC。在这 3 名患者中,息肉可见于整个结直肠。
尽管 HPS 在总体研究人群中是一种罕见疾病,但患有该疾病的患者可能有较高的 CRC 风险。应正确诊断 HPS 并仔细随访。