Division of Gastroenterology and Hepatology, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Dig Dis. 2020 Oct;21(10):558-565. doi: 10.1111/1751-2980.12928. Epub 2020 Sep 23.
Serrated polyps (SP) are regarded as precursor lesions of colorectal cancer (CRC). We conducted this single-center study aiming to investigate the relationship between SP and synchronous and metachronous advanced neoplasia in the Chinese population.
The data for this retrospective study were collected from the Endoscopy Center and Department of Gastroenterology of Renji Hospital, School of Medicine, Shanghai Jiao Tong University between May 2012 and May 2019. Altogether 2205 patients were pathologically confirmed with colorectal SP.
The detection rate of SP among all polyps has gradually increased since 2014 and reached 8.74% by 2019. Among all the SP cases, 1540 (69.84%) were confirmed as having hyperplasic polyps (HP), 486 (22.04%) were having sessile serrated lesions (SSL), and 171 (7.76%) had traditional serrated adenomas (TSA). Compared with HP (2.14%), SSL and TSA were larger and more likely to be accompanied by synchronous and metachronous advanced neoplasia (6.79% and 6.08%). We next found that large SP (diameter ≥10 mm) (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.40-4.55, P = 0.002) and SSL with high-grade intraepithelial neoplasia (OR 13.85, 95% CI 3.28-58.56, P < 0.001) were associated with an increased risk of synchronous advanced neoplasia. However, we failed to find a relationship between SP and metachronous advanced neoplasia because few patients had developed metachronous advanced neoplasia.
Large SP and SSL with high-grade intraepithelial neoplasia are associated with synchronous advanced neoplasia and require timely surveillance.
锯齿状息肉（SP）被认为是结直肠癌（CRC）的前体病变。我们进行了这项单中心研究，旨在探讨 SP 与中国人群中同时性和异时性高级别腺瘤的关系。
本回顾性研究的数据来自于 2012 年 5 月至 2019 年 5 月上海交通大学医学院附属仁济医院内镜中心和消化内科。共有 2205 例患者经病理证实为结直肠 SP。
自 2014 年以来，SP 在所有息肉中的检出率逐渐增加，到 2019 年达到 8.74%。在所有 SP 病例中，1540 例（69.84%）为增生性息肉（HP），486 例（22.04%）为无蒂锯齿状病变（SSL），171 例（7.76%）为传统锯齿状腺瘤（TSA）。与 HP（2.14%）相比，SSL 和 TSA 较大，更可能伴有同时性和异时性高级别腺瘤（6.79%和 6.08%）。我们发现，大 SP（直径≥10mm）（比值比[OR] 2.52，95%置信区间[CI] 1.40-4.55，P=0.002）和高级别上皮内瘤变的 SSL（OR 13.85，95%CI 3.28-58.56，P<0.001）与同时性高级别腺瘤的风险增加相关。然而，我们没有发现 SP 与异时性高级别腺瘤之间的关系，因为很少有患者发生异时性高级别腺瘤。
大 SP 和高级别上皮内瘤变的 SSL 与同时性高级别腺瘤相关，需要及时监测。
