Yao Bing-Yue, Zhang Li, Wu Chuan-Xia, Zheng Liang, Duan Ben-Song, Xu Qin-Wei, Lian Jing-Jing, Zhang Hai-Bin, Wang Yu, Cao Jia
Department of Gastroenterology, Endoscopy Center, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Pathology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Turk J Gastroenterol. 2024 Nov 11;36(1):15-23. doi: 10.5152/tjg.2024.24188.
BACKGROUND/AIMS: Growing recognition identifies sessile serrated lesions (SSL) as colorectal cancer (CRC) precursors. However, the SSL detection rate remains debatable and lacks a definitive consensus. Additionally, understanding the influencing factors in SSL development is limited. We aim to retrospectively analyze the true prevalence and risk factors of SSL in China.
This retrospective study collected medical data from patients who underwent colonoscopy at the Endoscopy Center of Shanghai East Hospital affiliated with Tongji University between March 1, 2019 and February 28, 2022. Data were sourced through the electronic medical record system and included information such as age, sex, lesion location, number, and pathology. This study predominantly focused on the detection rate and the clinical and endoscopic features of SSL.
Of 72 287 colonoscopies in 3 years, 3905 cases were histologically confirmed as SSL. Among them, 2290 (58.6%) were male, and 1615 (41.4%) were female. The overall SSL detection rate was 5.40%, slightly surpassing Asian/Chinese averages but lower than Western rates. Males had a higher SSL detection rate (6.1%) than females (4.6%). Univariate analysis revealed a significant association between SSL with dysplasia/adenocarcinoma (SSL-D/AD) and obesity (Body Mass Index, BMI ≥ 24), CRC family history, and hypertension. After multivariable logistic regression, only obesity (BMI ≥ 24) remained a statistically significant independent risk factor for SSL-D/AD.
The SSL detection rate at our center is 5.4% and increases with age. Males have a significantly higher detection rate than females. Our findings suggest that endoscopists should consider risk factors for SSL-D/AD, such as obesity, CRC family history, and hypertension.
背景/目的：越来越多的认识将无蒂锯齿状病变（SSL）视为结直肠癌（CRC）的前驱病变。然而，SSL的检出率仍存在争议，且缺乏明确的共识。此外，对SSL发生发展影响因素的了解有限。我们旨在回顾性分析中国SSL的真实患病率及危险因素。
这项回顾性研究收集了2019年3月1日至2022年2月28日在同济大学附属上海东方医院内镜中心接受结肠镜检查患者的医疗数据。数据通过电子病历系统获取，包括年龄、性别、病变部位、数量及病理等信息。本研究主要关注SSL的检出率以及临床和内镜特征。
3年中72287例结肠镜检查中，3905例经组织学确诊为SSL。其中，男性2290例（58.6%），女性1615例（41.4%）。SSL总体检出率为5.40%，略高于亚洲/中国平均水平，但低于西方水平。男性SSL检出率（6.1%）高于女性（4.6%）。单因素分析显示，SSL与发育异常/腺癌（SSL-D/AD）、肥胖（体重指数，BMI≥24）、CRC家族史和高血压之间存在显著关联。多变量逻辑回归分析后，仅肥胖（BMI≥24）仍是SSL-D/AD的一项具有统计学意义的独立危险因素。
我们中心的SSL检出率为5.4%，且随年龄增长而增加。男性检出率显著高于女性。我们的研究结果表明，内镜医师应考虑SSL-D/AD的危险因素，如肥胖、CRC家族史和高血压。
