增生样小直肠乙状结肠息肉中无蒂锯齿状腺瘤/息肉的发生率。
Prevalence of sessile serrated adenoma/polyp in hyperplastic-appearing diminutive rectosigmoid polyps.
机构信息
Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
出版信息
Gastrointest Endosc. 2017 Mar;85(3):622-627. doi: 10.1016/j.gie.2016.10.022. Epub 2016 Oct 19.
BACKGROUND AND AIMS
The American Society for Gastrointestinal Endoscopy recommends that distal colon hyperplastic lesions can be left in place without resection if adenomatous histology can be excluded with >90% negative predictive value. However, some lesions could be sessile serrated adenomas/polyps (SSA/Ps), which is also precancerous. The aim of this study was to describe the prevalence of SSA/Ps in hyperplastic-appearing diminutive rectosigmoid polyps.
METHODS
We prospectively placed 513 consecutive diminutive rectosigmoid polyps that appeared hyperplastic to an expert endoscopist in individual bottles for pathologic. Each polyp was examined by 3 expert GI pathologists.
RESULTS
The prevalence of SSA/P in the study polyps ranged from .6% to 2.1%. The lowest negative predictive value found by the endoscopist for the combination of adenomas plus SSA/Ps was 96.7%.
CONCLUSIONS
The prevalence of SSA/Ps in diminutive rectosigmoid hyperplastic-appearing polyps is very low. These results support the safety and feasibility of a "do not resect" policy for diminutive hyperplastic-appearing rectosigmoid polyps.
背景与目的
美国胃肠内镜学会建议，如果腺瘤组织学可以排除 90%以上的阴性预测值，则可以将远端结肠增生性病变留在原处而无需切除。然而，一些病变可能是无蒂锯齿状腺瘤/息肉（SSA/Ps），也是癌前病变。本研究的目的是描述增生性小直肠乙状结肠息肉中 SSA/Ps 的患病率。
方法
我们前瞻性地将 513 个连续的小直肠乙状结肠增生性息肉，由一位专家内镜医生放入单独的瓶子中进行病理检查。每个息肉都由 3 位专家胃肠病理学家进行检查。
结果
研究中息肉的 SSA/P 患病率为 0.6%至 2.1%。内镜医生对腺瘤和 SSA/Ps 组合的最低阴性预测值为 96.7%。
结论
小直肠乙状结肠增生性息肉中 SSA/Ps 的患病率非常低。这些结果支持对小直肠乙状结肠增生性息肉采取“不切除”政策的安全性和可行性。
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