Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital.
Department of Critical Care Medicine, Taichung Veterans General Hospital.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(12):1495-1504. doi: 10.1097/MEG.0000000000002062.
The aim of this systemic review and meta-analysis was to evaluate the prevalence of sessile serrated lesion (SSL) and its relationship to synchronous colorectal advanced neoplasia.
Comprehensive, computerized research was performed on PubMed and published from 1 January 2010 to 6 July 2018 which searched relevant articles without any language limitations. Clinical trials were included in the narrative systemic review if they matched the following inclusion criteria: (1) published as a case-controlled study, cohort study or cross-sectional study; (2) defined objectively for diagnosis of SSL within the studies; (3) addressed the prevalence and characteristics of SSL. Within these trials, if they met additional criteria involving the reported outcome of risk regarding advanced neoplasia in relation to SSL, they were enrolled into meta-analysis.
Forty-one trials were enrolled for the systematic review, with a total of eight analyzed for the meta-analysis. The prevalence of all SSL ranged from 0.038 to 20.23% and the prevalence by pooled analysis was 2.7%. In a subgroup analysis, the overall prevalence of SSL during the periods of 2010-2014 and 2015-2018 was shown to be 2.7 and 2.8%, respectively. We calculated the pooled data on the cancer risk of SSL and the risk of synchronous advanced neoplasia in patients with SSL made available from the eight trials, which resulted in a pooled odds ratio of 3.53 (95% confidence interval 2.39-5.20, I2 = 4%, P = 0.40).
In this systemic review, SSL was found to be associated with an increased risk of synchronous advanced neoplasia in the colorectum.
本系统评价和荟萃分析的目的是评估无蒂锯齿状病变（SSL）的患病率及其与结直肠同时性高级别肿瘤的关系。
我们在 PubMed 上进行了全面的计算机检索，并对 2010 年 1 月 1 日至 2018 年 7 月 6 日期间发表的文章进行了检索，检索时未对语言进行任何限制。如果临床试验符合以下纳入标准，则纳入叙述性系统评价：（1）发表为病例对照研究、队列研究或横断面研究；（2）在研究中客观地定义 SSL 的诊断；（3）涉及 SSL 的患病率和特征。在这些试验中，如果它们符合涉及 SSL 与高级别肿瘤相关的风险报告结果的其他标准，则被纳入荟萃分析。
共有 41 项试验被纳入系统评价，其中 8 项进行了荟萃分析。所有 SSL 的患病率范围为 0.038%至 20.23%，汇总分析的患病率为 2.7%。在亚组分析中，2010-2014 年和 2015-2018 年期间 SSL 的总体患病率分别为 2.7%和 2.8%。我们计算了这 8 项试验中提供的 SSL 癌症风险和 SSL 患者同时性高级别肿瘤风险的汇总数据，结果汇总优势比为 3.53（95%置信区间 2.39-5.20，I²=4%，P=0.40）。
在本系统评价中，SSL 与结直肠同时性高级别肿瘤的风险增加相关。
