Differentiation between sessile serrated adenoma/polyp and non-sessile serrated adenoma/polyp in large hyper plastic polyp: A Japanese collaborative study
Differentiation between sessile serrated adenoma/polyp and non-sessile serrated adenoma/polyp in large hyper plastic polyp: A Japanese collaborative study
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DOI：
10.3892/mco.2012.20
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发表时间：
2013-01-01
影响因子：
1.2
通讯作者：
Kato, Hiroyuki
中科院分区：
文献类型：
--
作者：
Shida, Yosuke;Ichikawa, Kazuhito;Kato, Hiroyuki
增生性息肉 (HP) > 10 mm 被描述为大增生性息肉 (LHP)。先前的研究认为 LHP 和无蒂锯齿状腺瘤/息肉 (SSA/P) 是同义词。尽管 HP 和 SSA/P 之前已在形态上进行了区分，但 LHP 和 SSA/P 之间的差异尚未有报道。本研究旨在使用 Ki67 的免疫组织化学来定义 LHP 中 SSA/P 和非 SSA/P 之间的差异。通过内窥镜完全切除的结直肠锯齿状病变（> 10 mm），来自日本11家机构[独协医科大学医学院（壬生）、藤井隆宏诊所（东京）、佐野医院（神户）、小田胃肠诊所、服部胃肠镜和肿瘤诊所（熊本）、太田诊所（名古屋）、广岛大学（广岛）、岩手医科大学2003 年 1 月至 2010 年 12 月期间隶属于日本结直肠癌协会 (JSCCR) 的日本结直肠癌协会 (盛冈)、顺天堂大学和杏林大学 (东京) 以及富山大学 (富山) 被选中。采用日本结直肠癌协会（JSCCR，项目会议；主编 Takashi Yao）的组织学标准来区分 LHP 中的 SSA/P 和非 SSA/P。非SSA/P包括不完整的SSA/P和HP。总共使用了来自 148 名患者的 154 份诊断为 SSA/P 或非 SSA/P 的样本。该研究包括 107 例 SSA/P 和 47 例非 SSA/P 病例，病变位于结肠右侧（分别为 73.2% 和 26.8%）。与非 SSA/P 相比，SSA/P 中的 Ki67 阳性率显着更高。与左侧相比，LHP 中结肠右侧的 SSA/P 数量更多。发生在结肠右侧的SSA/P可能是锯齿状瘤形成途径中结直肠癌的前驱病变。总之，LHP和局限于右侧结肠的SSA/P在临床上建议作为同类型病变进行治疗。
A hyperplastic polyp (HP) > 10 mm is described as a large hyperplastic polyp (LHP). Previous studies have considered LHP and sessile serrated adenoma/polyp (SSA/P) as synonymous. Although HP and SSA/P have previously been morphologically distinguished, differences between LHP and SSA/P have not yet been reported. The present study aimed to define the differences between SSA/P and non-SSA/P in LHP using immunohistochemistry for Ki67. Colorectal serrated lesions (> 10 mm) that were completely resected by endoscope and derived from 11 institutions in Japan [Dokkyo Medical University School of Medicine (Mibu), Takahiro Fujii Clinic (Tokyo), Sano Hospital (Kobe), Oda GI Clinic, Hattori GI Endoscopy and Oncology Clinic (Kumamoto), Ohta Clinic (Nagoya), Hiroshima University (Hiroshima), Iwate Medical University (Morioka), Juntendo and Kyorin Universities (Tokyo) as well as Toyama University (Toyama)] affiliated with the Japanese Society for Cancer of the Colon and Rectum (JSCCR) between January 2003 and December 2010 were selected. The histological criteria of the Japanese Society for Cancer of the Colon and Rectum (JSCCR, project meeting; editor-in chief, Takashi Yao) were used to distinguish SSA/P and non-SSA/P from LHP. Non-SSA/P comprises both incomplete SSA/P and HP. A total of 154 samples diagnosed as SSA/P or non-SSA/P from 148 patients were used. This study comprised 107 SSA/P and 47 non-SSA/P cases, whereby lesions were located on the right side of the colon (73.2 and 26.8%, respectively). Ki67-positivity in SSA/Ps was significantly higher compared to non-SSA/Ps. A greater number of SSA/Ps in LHP were located on the right side of the colon compared to the left side. SSA/Ps occurring on the right side of the colon may be precursor lesions of colorectal carcinoma in serrated neoplasia pathways. In conclusion, LHPs and SSA/Ps limited to the right side of the colon are suggested to be clinically treated as the same type of lesions.