Seo Ji Yeon, Choi Seung Ho, Chun Jaeyoung, Lee Changhyun, Choi Ji Min, Jin Eun Hyo, Hwang Sung Wook, Im Jong Pil, Kim Sang Gyun, Kim Joo Sung
Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Intest Res. 2016 Jul;14(3):270-9. doi: 10.5217/ir.2016.14.3.270. Epub 2016 Jun 27.
BACKGROUND/AIMS: The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.
Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.
Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.
Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.
背景/目的：源自无蒂锯齿状腺瘤或传统锯齿状腺瘤的结直肠癌内镜切除的疗效和安全性仍不明确。本研究的目的是验证由锯齿状息肉发展而来的早期结直肠癌内镜切除的特征和结果。
纳入2008年至2011年接受早期结直肠癌内镜切除的患者中，有记录显示存在先前病变的癌症。根据基线病变将其分为腺瘤、无蒂锯齿状腺瘤或传统锯齿状腺瘤。回顾临床特征、病理诊断和结果。
总体而言，纳入了198例患者中检测到的208例结直肠癌：198例为腺瘤，5例为无蒂锯齿状腺瘤，5例为传统锯齿状腺瘤。无蒂锯齿状腺瘤组的高级别异型增生患病率高于腺瘤组（40.0%对25.8%，P<0.001）。在随访期间，由锯齿状息肉发展而来的早期结直肠癌内镜切除后未发生局部复发。相比之下，在短时间随访内检测到2例异时性复发。
当怀疑结直肠癌源自锯齿状息肉时，建议谨慎观察并尽早进行内镜切除。源自锯齿状息肉的结直肠癌可以通过内镜成功治疗。
