Cao Hai-Long, Chen Xue, Du Shao-Chun, Song Wen-Jing, Wang Wei-Qiang, Xu Meng-Que, Wang Si-Nan, Piao Mei-Yu, Cao Xiao-Cang, Wang Bang-Mao
Department of Gastroenterology and Hepatology, Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Pathology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Chin Med J (Engl). 2016 Oct 20;129(20):2427-2433. doi: 10.4103/0366-6999.191759.
Colorectal serrated polyp is considered as histologically heterogeneous lesions with malignant potential in western countries. However, few Asian studies have investigated the comprehensive clinical features of serrated polyps in symptomatic populations. The aim of the study was to evaluate the features of colorectal serrated polyps in a Chinese symptomatic population.
Data from all consecutive symptomatic patients were documented from a large colonoscopy database and were analyzed. Chi-square test or Fisher's exact test and logistic regression analysis were used for the data processing.
A total of 9191 (31.7%) patients were detected with at least one colorectal polyp. The prevalence of serrated polyps was 0.53% (153/28,981). The proportions of hyperplastic polyp (HP), sessile serrated adenoma/polyp (SSA/P), and traditional serrated adenoma (TSA) of all serrated polyps were 41.2%, 7.2%, and 51.6%, respectively, which showed a lower proportion of HP and SSA/P and a higher proportion of TSA. Serrated polyps appeared more in males and elder patients while there was no significant difference in the subtype distribution in gender and age. The proportions of large and proximal serrated polyps were 13.7% (21/153) and 46.4% (71/153), respectively. In total, 98.9% (89/90) serrated adenomas were found with dysplasia. Moreover, 14 patients with serrated polyps were found with synchronous advanced colorectal neoplasia, and large serrated polyps (LSPs) (odds ratio: 3.446, 95% confidence interval: 1.010-11.750, P < 0.05), especially large HPs, might have an association with synchronous advanced neoplasia (AN).
The overall detection rate of colorectal serrated polyps in Chinese symptomatic patient population was low, and distribution pattern of three subtypes is different from previous reports. Moreover, LSPs, especially large HPs, might be associated with an increased risk of synchronous AN.
在西方国家，结直肠锯齿状息肉被认为是具有恶性潜能的组织学异质性病变。然而，很少有亚洲研究调查有症状人群中锯齿状息肉的综合临床特征。本研究的目的是评估中国有症状人群中结直肠锯齿状息肉的特征。
从一个大型结肠镜检查数据库中记录所有连续有症状患者的数据并进行分析。采用卡方检验或费舍尔精确检验以及逻辑回归分析进行数据处理。
总共9191名（31.7%）患者被检测出至少有一个结直肠息肉。锯齿状息肉的患病率为0.53%（153/28981）。所有锯齿状息肉中增生性息肉（HP）、无蒂锯齿状腺瘤/息肉（SSA/P）和传统锯齿状腺瘤（TSA）的比例分别为41.2%、7.2%和51.6%，显示HP和SSA/P的比例较低，TSA的比例较高。锯齿状息肉在男性和老年患者中更常见，而在性别和年龄方面亚型分布没有显著差异。大的和近端锯齿状息肉的比例分别为13.7%（21/153）和46.4%（71/153）。总共98.9%（89/90）的锯齿状腺瘤被发现有发育异常。此外，14名有锯齿状息肉的患者被发现有同步性进展期结直肠肿瘤，大的锯齿状息肉（LSPs）（比值比：3.446，95%置信区间：1.010 - 11.750，P < 0.05），尤其是大的HP，可能与同步性进展期肿瘤（AN）有关。
中国有症状患者人群中结直肠锯齿状息肉的总体检出率较低，三种亚型的分布模式与以往报道不同。此外，LSPs，尤其是大的HP，可能与同步性AN的风险增加有关。
