Prevalence and Clinical Features of Sessile Serrated Polyps: A Systematic Review.
Prevalence and Clinical Features of Sessile Serrated Polyps: A Systematic Review.
复制标题
DOI：
10.1053/j.gastro.2020.03.025
复制
发表时间：
2020-07
期刊：
影响因子：
29.4
通讯作者：
Ladabaum U
中科院分区：
文献类型：
--
作者：
Meester RGS;van Herk MMAGC;Lansdorp-Vogelaar I;Ladabaum U
无蒂锯齿状息肉（SSP）可能占结直肠癌的很大比例。我们的目的是提高SSP患病率和临床特征的清晰度。我们对Medline、Web of Science、Embase和科克伦数据库中自2000年以来以英文发表的原始研究进行了系统综述。我们纳入了不同人群的研究（美国普通或类似），干预措施（结肠镜检查，尸检），比较（世界地区，替代息肉定义，腺瘤），结局（患病率，临床特征）和研究设计（横断面）。在可能的情况下，使用随机效应回归进行荟萃分析。我们确定了74项相关的结肠镜检查研究。SSP患病率因世界地区而异，从亚洲的2.6%（95% CI，0-5.9%）到澳大利亚的10.5%（95% CI，2.8%-18.2%）。美国和欧洲之间的患病率值没有显著差异（P= 0.51）;合并患病率为4.6%（95% CI，3.4%-5.8%），SSP占具有恶性潜能的息肉的9.4%（95% CI，6.6%-12.3%）。通过高性能检查评估的平均患病率更高（9.1%; 95% CI，4.0%-14.2%，P= 0.04），并与临床相关的锯齿状息肉的替代定义（12.3%; 95% CI，9.3%-15.4%; P<0.001）。患病率随年龄的增长没有统计学意义，患病率在性别之间没有显著差异。与腺瘤相比，孤立性SSP（69.0%; 95% CI，45.9%-92.1%; P= 0.08）、直径≥ 10 mm（19.3%; 95% CI，12.4%-26.2%; P= 0.13）和近端SSP（71.5%; 95% CI，63.5%-79.5%; P= 0.009）的比例较高。无异型增生、有任何或低度异型增生和高度异型增生的SSP检测的平均年龄分别为60.8岁、65.6岁和70.2岁。各研究中发育不良SSP的比例范围为3.7%-42.9%，可能反映了不同的研究人群。在一项系统回顾中，我们发现与腺瘤相比，无蒂锯齿状息肉相对少见。需要对适当的诊断标准、检测的变化和长期风险进行更多的研究。
Sessile serrated polyps (SSPs) could account for a substantial proportion of colorectal cancers. We aimed to increase clarity on SSP prevalence and clinical features. We performed a systematic review of Medline, Web of Science, Embase, and Cochrane databases for original studies published in English since 2000. We included studies of different populations (United States general or similar), interventions (colonoscopy, autopsy), comparisons (world regions, alternative polyp definitions, adenoma), outcomes (prevalence, clinical features), and study designs (cross-sectional). Random-effects regression was used for meta-analysis where possible. We identified 74 relevant colonoscopy studies. SSP prevalence varied by world region, from 2.6% in Asia (95% CI, 0–5.9%) to 10.5% in Australia (95% CI, 2.8%–18.2%). Prevalence values did not differ significantly between the United States and Europe (P=.51); the pooled prevalence was 4.6% (95% CI, 3.4%–5.8%), and SSPs accounted for 9.4% of polyps with malignant potential (95% CI, 6.6%–12.3%). Mean prevalence was higher when assessed through high-performance exams (9.1%; 95% CI, 4.0%–14.2%, P=.04) and with alternative definition of clinically relevant serrated polyps (12.3%; 95% CI, 9.3%–15.4%; P<.001). Increases in prevalence with age were not statistically significant, and prevalence did not differ significantly by sex. Compared with adenomas, a higher proportion of SSPs were solitary (69.0%; 95% CI, 45.9%–92.1%; P=.08), with diameters of 10 mm or more (19.3%; 95% CI, 12.4%–26.2%; P=.13), and were proximal (71.5%; 95% CI, 63.5%–79.5%; P=.009). Mean ages for detection of SSP without dysplasia, with any or low-grade dysplasia, and with high-grade dysplasia were 60.8 y, 65.6 y, and 70.2 y, respectively. The range for proportion of SSPs with dysplasia was 3.7%–42.9% across studies, possibly reflecting different study populations. In a systematic review, we found that sessile serrated polyps are relatively uncommon, compared with adenoma. More research is needed on appropriate diagnostic criteria, variations in detection, and long-term risk.
登录
查看更多内容
影响因子：
3.9
作者：
ARMINSKI, T. C.;McLEAN, D. W.
通讯作者：
McLEAN, D. W.
影响因子：
3.3
作者：
Bouwens, Marielle W. E.;Winkens, Bjorn;Sanduleanu, Silvia
通讯作者：
Sanduleanu, Silvia
影响因子：
12.6
作者：
Anderson, Joseph C.;Butterly, Lynn F.;Weiss, Julia E.
通讯作者：
Weiss, Julia E.
影响因子：
7.7
作者：
Alvarez, Cristina;Andreu, Montserrat;Bessa, Xavier
通讯作者：
Bessa, Xavier
影响因子：
2.1
作者：
Bettington, Mark;Walker, Neal;Croese, John
通讯作者：
Croese, John