Parikh Malav P, Muthukuru Sujit, Jobanputra Yash, Naha Kushal, Gupta Niyati M, Wadhwa Vaibhav, Lopez Rocio, Thota Prashanthi N, Sanaka Madhusudhan R
Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Department of Internal Medicine, Presence Saint Francis Hospital, 355 Ridge Ave, Evanston, IL 60202, USA.
Gastroenterol Res Pract. 2017;2017:6710931. doi: 10.1155/2017/6710931. Epub 2017 Dec 18.
Proximal sessile serrated adenomas (PSSA) leading to colorectal cancer (CRC) represent an alternate pathway for CRC development. In this study, we aim to determine the prevalence of PSSAs and the impact of patient, colonoscopy, and endoscopist-related factors on PSSA detection.
Patients ≥ 50 years of age undergoing a screening colonoscopy between 2012 and 2014 were included. Detection rates based on patient gender, race, colonoscopy timing, fellow participation, bowel preparation quality, and specialty of the endoscopist were calculated. -tests were used to compare detection rates and a multivariate-adjusted analysis was performed.
140 PSSAs were detected from 4151 colonoscopies, with a prevalence of 3.4%. Detection rate was higher in Caucasians compared to African-Americans (AA) (3.7 ± 4.1 versus 0.96 ± 3.5; < 0.001). Gastroenterologists detected more PSSAs compared to nongastroenterologists (3.9 ± 3.5 versus 2.2 ± 3.0; = 0.028). These findings were still significant after adjusted multivariate analysis. The rest of the factors did not make significant difference in PSSA detection rate.
PSSAs are more prevalent in Caucasians compared to AAs. Racial difference in prevalence of PSSAs is intriguing and warrants further investigation. Gastroenterologists have a significantly higher PSSADR compared to nongastroenterologists. Educational measures should be implemented in nongastroenterologists to improve their PSSA detection rates.
导致结直肠癌（CRC）的近端无蒂锯齿状腺瘤（PSSA）代表了结直肠癌发生的另一条途径。在本研究中，我们旨在确定PSSA的患病率以及患者、结肠镜检查和内镜医师相关因素对PSSA检测的影响。
纳入2012年至2014年间接受筛查结肠镜检查的年龄≥50岁的患者。计算基于患者性别、种族、结肠镜检查时间、助手参与情况、肠道准备质量和内镜医师专业的检出率。采用t检验比较检出率并进行多变量调整分析。
在4151例结肠镜检查中检测到140例PSSA，患病率为3.4%。与非裔美国人（AA）相比，白种人的检出率更高（3.7±4.1对0.96±3.5；P<0.001）。与非胃肠病学家相比，胃肠病学家检测到更多的PSSA（3.9±3.5对2.2±3.0；P=0.028）。经过多变量调整分析后，这些结果仍然显著。其余因素在PSSA检出率方面没有显著差异。
与非裔美国人相比，白种人中PSSA更为普遍。PSSA患病率的种族差异很有趣，值得进一步研究。与非胃肠病学家相比，胃肠病学家的PSSA检出率显著更高。应针对非胃肠病学家采取教育措施，以提高他们对PSSA的检出率。
