Kim Eun Ran, Jeon Jaryong, Lee Jin Hee, Lee Yoon Jung, Hong Sung Noh, Chang Dong Kyung, Kim Young-Ho
Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Intest Res. 2017 Jul;15(3):402-410. doi: 10.5217/ir.2017.15.3.402. Epub 2017 Jun 12.
BACKGROUND/AIMS: Serrated polyposis syndrome (SPS) has been shown to increase the risk of colorectal cancer (CRC). However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review.
This retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011.
Twenty patients (67%) were male. The median patient age at diagnosis was 56 years (range, 39-76 years). A total of 702 polyps were identified during a median follow-up of 43 months (range, 0-149 months). Serrated polyps were noted more frequently in the distal colon (298/702, 55%). However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively); 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients), but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions.
The phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.
背景/目的：锯齿状息肉病综合征（SPS）已被证实会增加患结直肠癌（CRC）的风险。然而，关于亚洲SPS患者的特征知之甚少。本研究旨在确定韩国SPS患者的临床病理特征及患CRC的风险，并通过文献综述探讨韩国患者与西方患者之间的差异。
这项回顾性研究纳入了1999年3月至2011年5月在韩国三星医疗中心按照世界卫生组织分类标准确诊的30例SPS患者。
20例（67%）为男性。诊断时患者的中位年龄为56岁（范围39 - 76岁）。在中位随访43个月（范围0 - 149个月）期间共发现702个息肉。锯齿状息肉在远端结肠更为常见（298/702，55%）。然而，大的锯齿状息肉和锯齿状腺瘤主要分布在整个近端结肠（分别为75%对25%和81%对19%）；73.3%的患者有同步腺瘤性息肉。CRC的发生率为10%（3/30例患者），但未检测到间隔期CRC。87%的患者接受了食管胃十二指肠镜检查，19.2%有明显病变。
韩国患者的SPS表型与西方患者不同。在韩国患者中，SPS在男性中更常见，锯齿状腺瘤/息肉总数较少，CRC的发生率低于西方患者。韩国患者往往更频繁地出现胃部异常病变。然而，西方和韩国患者中同步腺瘤性息肉的患病率都很高。
