Moy Brian T, Forouhar Faripour, Kuo Chia-Ling, Devers Thomas J
Division of Gastroenterology and Hepatology, UConn Health, Farmington, CT, USA.
Department of Pathology, UConn Health, Farmington, CT, USA.
Clin Endosc. 2018 Jul;51(4):368-374. doi: 10.5946/ce.2017.155. Epub 2018 Apr 27.
BACKGROUND/AIMS: The aims of the study were to identify whether a mucous-cap predicts the presence of serrated polyps, and to determine whether additional endoscopic findings predict the presence of a sessile serrated adenomas/polyp (SSA/P).
We analyzed 147 mucous-capped polyps with corresponding histology, during 2011-2014. Eight endoscopic features (presence of borders, elevation, rim of debris, location in the colon, size ≥10 mm, varicose vessels, nodularity, and alteration in mucosal folds) of mucous-capped polyps were examined to see if they can predict SSA/Ps.
A total of 86% (n=126) of mucous-capped polyps were from the right sided serrated pathway (right-sided hyperplastic [n=83], SSA/Ps [n=43], traditional serrated adenoma [n=1]), 10% (n=15) were left-sided hyperplastic polyps, and 3% (n=5) were from the adenoma-carcinoma sequence. The presence of a mucous cap combined with varicose vessels was the only significant predictor for SSA/Ps. The other seven characteristics were not found to be statistically significant for SSA/Ps, although location in the colon and the presence of nodularity trended towards significance.
Our study suggests that mucous-capped polyps have high predictability for being a part of the serrated pathway. Gastroenterologists should be alert for a mucous-capped polyp with varicose veins, as these lesions have a higher risk of SSA/P.
背景/目的：本研究的目的是确定黏液帽是否可预测锯齿状息肉的存在，并确定其他内镜检查结果是否可预测无蒂锯齿状腺瘤/息肉（SSA/P）。
我们分析了2011年至2014年间147个有相应组织学结果的黏液帽息肉。检查黏液帽息肉的八个内镜特征（边界、隆起、碎片边缘、结肠位置、大小≥10毫米、曲张血管、结节状、黏膜皱襞改变），以确定它们是否能预测SSA/P。
总共86%（n = 126）的黏液帽息肉来自右侧锯齿状途径（右侧增生性息肉[n = 83]、SSA/P[n = 43]、传统锯齿状腺瘤[n = 1]），10%（n = 15）为左侧增生性息肉，3%（n = 5）来自腺瘤-癌序列。黏液帽与曲张血管同时存在是SSA/P的唯一显著预测指标。其他七个特征对SSA/P无统计学意义，尽管结肠位置和结节状的存在有显著趋势。
我们的研究表明，黏液帽息肉作为锯齿状途径一部分的预测性很高。胃肠病学家应警惕有曲张静脉的黏液帽息肉，因为这些病变发生SSA/P的风险更高。
