Prevalence of serrated polyps and association with synchronous advanced neoplasia in screening colonoscopy
Prevalence of serrated polyps and association with synchronous advanced neoplasia in screening colonoscopy
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DOI：
10.1055/s-0033-1358800
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发表时间：
2014-03-01
期刊：
影响因子：
9.3
通讯作者：
Dekker, Evelien
中科院分区：
文献类型：
--
作者：
Hazewinkel, Yark;de Wijkerslooth, Thomas R.;Dekker, Evelien
背景和研究目的：大肠锯齿状息肉是一组具有不同组织学和恶性特征的异质性病变。这项研究的目的是估计锯齿状息肉亚型的患病率在一个队列的个人进行筛选结肠镜检查，并确定锯齿状息肉亚型和先进neoplasia.Patients和方法检测之间的关联：锯齿状息肉，腺瘤和癌症的数据收集从参与者的随机筛选试验，比较结肠镜检查与计算机断层扫描结肠造影。仅使用结肠镜检查组参与者的数据。进行逻辑回归分析，以确定患者的年龄、性别和不同类型锯齿状息肉的患病率之间的关系，并确定这些息肉的检测与晚期肿瘤之间的关系（定义为腺瘤>= 10 mm、绒毛成分、高度异型增生或结直肠癌）。共纳入了1426名中位年龄为60岁（IQR 55-65）的初筛个体（51%男性）。增生性息肉、无蒂锯齿状腺瘤/息肉（SSA/Ps）和传统锯齿状腺瘤（TSA）的患病率分别为23.8%、4.8%和0.1%。SSA/Ps占所有息肉的7.3%。SSA/Ps的患病率没有观察到基于年龄或性别的差异。近端和大（>= 10 mm）增生性息肉，以及近端和大（>= 10 mm）SSA/Ps，与同步进展期neoplasia.Conclusions：锯齿状息肉，包括SSA/Ps，经常遇到在常规筛查结肠镜。大的和近端增生性息肉，以及大的和近端SSA/Ps，与晚期瘤形成相关。
Background and study aims: Serrated polyps of the large intestine comprise a heterogeneous group of lesions with distinct histological and malignant features. The aim of the study was to estimate the prevalence of serrated polyp subtypes in a cohort of individuals undergoing screening colonoscopy, and to identify associations between the detection of serrated polyp subtypes and advanced neoplasia.Patients and methods: Data on serrated polyps, adenomas, and cancers were collected from participants of a randomized screening trial that compared colonoscopy with computed tomography colonography. Only data from participants in the colonoscopy arm were used. Logistic regression analyses were performed to identify associations between patients' age, sex, and prevalence of the different types of serrated polyps and to identify associations between the detection of these polyps and advanced neoplasia (defined as an adenoma >= 10mm, villous component, high grade dysplasia or colorectal cancer).Results: A total of 1426 screen-naive individuals (51% male) with a median age of 60 years (IQR 55-65) were included. The prevalence of hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas (TSAs) was 23.8 %, 4.8 %, and 0.1 %, respectively. SSA/Ps comprised 7.3% of all polyps. No differences based on age or sex were observed in the prevalence of SSA/Ps. Proximal and large (>= 10 mm) hyperplastic polyps, as well as proximal and large (>= 10mm) SSA/Ps, were associated with synchronous advanced neoplasia.Conclusions: Serrated polyps, including SSA/Ps, were frequently encountered in routine screening colonoscopies. Large and proximal hyperplastic polyps, as well large and proximal SSA/Ps, were associated with advanced neoplasia.