1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York 2Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 3Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Dis Colon Rectum. 2014 Jul;57(7):846-50. doi: 10.1097/DCR.0000000000000140.
Serrated polyposis syndrome is a rare syndrome associated with an increased risk for colorectal cancer. The World Health Organization criteria were established to standardize the diagnosis and management of patients afflicted with serrated polyposis. Although useful, the criteria may not be ideal for the initial screening of at-risk populations.
The aim of this study was to examine the use of a minimal cutoff point of serrated lesions to increase the yield of serrated polyposis cases.
This was a retrospective review of colonoscopy and pathology reports to identify patients who met the World Health Organization criteria for serrated polyposis.
This study was conducted at a tertiary cancer care referral center.
Five hundred patients who had at least 2 pathologically confirmed hyperplastic polyps and/or sessile serrated adenomas/polyps diagnosed between 1999 and 2009 were assessed.
The primary outcome measure was the number of serrated polyposis cases.
Forty of the 500 (8%) patients met the World Health Organization criteria for serrated polyposis syndrome. Patients underwent a median of 4 colonoscopies (range, 1-23) before satisfying the criteria, and only 1 (3%) patient met the criteria for diagnosis during the initial colonoscopy. All 16 patients with a history of colorectal cancer were only diagnosed with serrated polyposis either at the time of their cancer diagnosis or during postoperative colonoscopies. Only 5 of the 40 (13%) patients were enrolled in our institutional Hereditary Colorectal Cancer Family Registry before our study for prospective serrated lesion tracking and colorectal cancer screening.
This tool requires validation in a prospective setting.
The cutoff point of at least 2 pathologically confirmed serrated lesions can serve as a screening tool for identifying patients meeting the World Health Organization criteria for serrated polyposis syndrome who would otherwise go undetected.
锯齿状息肉综合征是一种罕见的综合征，与结直肠癌风险增加有关。世界卫生组织的标准是为了规范患有锯齿状息肉的患者的诊断和管理而建立的。虽然这些标准很有用，但它们可能并不理想，无法用于高危人群的初步筛查。
本研究旨在探讨使用最少的锯齿病变截断值来增加锯齿状息肉病例的检出率。
这是一项对结肠镜检查和病理报告的回顾性研究，旨在确定符合世界卫生组织锯齿状息肉标准的患者。
这项研究在一家三级癌症治疗转诊中心进行。
评估了 500 名至少有 2 个经病理证实的增生性息肉和/或无蒂锯齿状腺瘤/息肉的患者，这些患者的诊断时间在 1999 年至 2009 年之间。
主要观察指标是锯齿状息肉病例的数量。
在 500 名患者中，有 40 名（8%）符合世界卫生组织锯齿状息肉综合征的标准。患者在满足标准之前接受了中位数为 4 次结肠镜检查（范围为 1-23 次），只有 1 名（3%）患者在首次结肠镜检查时就符合诊断标准。所有 16 名有结直肠癌病史的患者均在癌症诊断时或术后结肠镜检查时才被诊断为锯齿状息肉。在我们的研究之前，只有 40 名患者中的 5 名（13%）参加了我们机构的遗传性结直肠癌家族登记处，以便对锯齿状病变进行前瞻性跟踪和结直肠癌筛查。
该工具需要在前瞻性研究中进行验证。
至少有 2 个经病理证实的锯齿状病变的截断值可作为一种筛查工具，用于识别符合世界卫生组织锯齿状息肉综合征标准但可能未被发现的患者。
