Clinical and endoscopic characteristics of sessile serrated lesions with dysplasia/carcinoma
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Background/Aims: Some sessile serrated lesions (SSLs) progress into dysplasia and colorectal cancer, however, the clinical and endoscopic characteristics of SSLs with dysplasia remain to be determined. In this study, we elucidated these characteristics in SSLs with dysplasia/carcinoma, compared with those of SSLs without dysplasia. Methods: We retrospectively collected the clinical, endoscopic, and pathological data of 254 SSLs from 216 patients endoscopically resected between January 2009 and December 2020. Results: All SSLs included 179 without dysplasia and 75 with dysplasia/carcinoma, including 55 with low-grade dysplasia, 10 with high-grade dysplasia, and 10 with submucosal cancer. In clinical characteristics, SSLs with dysplasia/carcinoma were significantly associated with advanced age, metabolic diseases, and high-risk adenomas. In endoscopic characteristics, SSLs with dysplasia/carcinoma were significantly associated with the distal colon, large size, polypoid morphology, surface-changes, no mucus cap, and narrow-band imaging international colorectal endoscopic classification (NICE) type 2/3. In the multivariate analysis, high-risk adenomas (odds ratio [OR], 2.98; p = 0.01), large size (OR, 1.18; p < 0.01), depression (OR, 11.74; p = 0.03), and NICE type 2/3 (OR, 14.97; p < 0.01) were significantly associated with SSLs with dysplasia/carcinoma. Conclusions: SSLs had a higher risk of dysplasia in the distal colon than in the proximal colon. SSLs with large size, depression, and adenomatous surface-patterns, as well as those in patients with high-risk adenomas, increased the risk of dysplasia/ carcinoma. This suggests that the clinical and endoscopic characteristics can aid in the diagnosis and management of SSLs with dysplasia/carcinoma.
Abstract
Background/Aims: Some sessile serrated lesions (SSLs) progress into dysplasia and colorectal cancer, however, the clinical and endoscopic characteristics of SSLs with dysplasia remain to be determined. In this study, we elucidated these characteristics in SSLs with dysplasia/carcinoma, compared with those of SSLs without dysplasia. Methods: We retrospectively collected the clinical, endoscopic, and pathological data of 254 SSLs from 216 patients endoscopically resected between January 2009 and December 2020. Results: All SSLs included 179 without dysplasia and 75 with dysplasia/carcinoma, including 55 with low-grade dysplasia, 10 with high-grade dysplasia, and 10 with submucosal cancer. In clinical characteristics, SSLs with dysplasia/carcinoma were significantly associated with advanced age, metabolic diseases, and high-risk adenomas. In endoscopic characteristics, SSLs with dysplasia/carcinoma were significantly associated with the distal colon, large size, polypoid morphology, surface-changes, no mucus cap, and narrow-band imaging international colorectal endoscopic classification (NICE) type 2/3. In the multivariate analysis, high-risk adenomas (odds ratio [OR], 2.98; p = 0.01), large size (OR, 1.18; p < 0.01), depression (OR, 11.74; p = 0.03), and NICE type 2/3 (OR, 14.97; p < 0.01) were significantly associated with SSLs with dysplasia/carcinoma. Conclusions: SSLs had a higher risk of dysplasia in the distal colon than in the proximal colon. SSLs with large size, depression, and adenomatous surface-patterns, as well as those in patients with high-risk adenomas, increased the risk of dysplasia/ carcinoma. This suggests that the clinical and endoscopic characteristics can aid in the diagnosis and management of SSLs with dysplasia/carcinoma.
참고문헌 (46)
- Torlakovic E, "Morphologic reappraisal of serrated colorectal polyps", Am J Surg Pathol, 27, pp.65~81 (2003)
- Nagtegaal ID, "The 2019 WHO classification of tumours of the digestive system", Histopathology, 76, pp.182~188 (2020)
- Carr NJ, "Serrated and non-serrated polyps of the colorectum : their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma", J Clin Pathol, 62, pp.516~518 (2009)
- Lash RH, "Sessile serrated adenomas : prevalence of dysplasia and carcinoma in 2139 patients", J Clin Pathol, 63, pp.681~686 (2010)
- East JE, "Serrated lesions in colorectal cancer screening : detection, resection, pathology and surveillance", Gut, 64, pp.991~1000 (2015)
- Pohl H, "Incomplete polyp resection during colonoscopy-results of the complete adenoma resection(CARE)study", Gastroenterology, 144, pp.74~80 (2013)
- Abdeljawad K, "Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist", Gastrointest Endosc, 81, pp.517~524 (2015)
- Yang JF, "Anatomic distribution of sessile serrated adenoma", polyp with and without cytologic dysplasia, 2015, pp.139, 388~393
- Kambara T, "BRAF mutation is associated with DNA methylation in serrated polyps and cancers of the colorectum", Gut, 538, pp.1137~1144 (2004)
- O’Brien MJ, "Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points", Am J Surg Pathol, 30, pp.1491~1501 (2006)
- Patil DT, "Proximal colon cancers and the serrated pathway : a systematic analysis of precursor histology and BRAF mutation status", Mod Pathol, 25, pp.1423~1431 (2012)
- Crockett SD, "Terminology, molecular features, epidemiology, and management of serrated colorectal neoplasia", Gastroenterology, 157, pp.949~966 (2019)
- Goldstein NS, "Small colonic microsatellite unstable adenocarcinomas and high-grade epithelial dysplasias in sessile serrated adenoma polypectomy specimens : a study of eight cases", Am J Clin Pathol, 125, pp.132~145 (2006)
- Snover DC, "Update on the serrated pathway to colorectal carcinoma", Hum Pathol, 42, pp.1~10 (2011)
- Bettington M, "The serrated pathway to colorectal carcinoma : current concepts and challenges", Histopathology, 62, pp.367~386 (2013)
- Murakami T, "Distinct histopathological characteristics in colorectal submucosal invasive carcinoma arising in sessile serrated adenoma", polyp and conventional tubular adenoma, 2018, pp.472, 383~393
- Murakami T, "Clinicopathological features, diagnosis, and treatment of sessile serrated adenoma", polyp with dysplasia, J Gastroenterol Hepatol, pp.2019, 34[DOI]
- Bouwens MW, "Endoscopic characterization of sessile serrated adenomas", polyps with and without dysplasia, 2014, pp.46, 225~235
- Burgess NG, "Clinical and endoscopic predictors of cytological dysplasia or cancer in a prospective multicentre study of large sessile serrated adenomas", polyps, 2016, pp.65, 437~446
- Murakami T, "Distinct endoscopic characteristics of sessile serrated adenoma", polyp with and without dysplasia, Gastrointest Endosc, pp.2017, 85[DOI]
- Hassan C, "Post-polypectomy colonoscopy surveillance : European Society of Gastrointestinal Endoscopy(ESGE)guideline-update 2020", Endoscopy, 52, pp.687~700 (2020)
- WHO Classification of Tumours Editorial Board, "Digestive System Tumours: WHO Classification of Tumours. 5th ed. Vol.1" (2019), International Agency for Research on Cancer (IARC)Publications
- Murakami T, "Usefulness of the Japan narrow-band imaging expert team classification system for the diagnosis of sessile serrated lesion with dysplasia", carcinoma, 2021, pp.35, 4528~4538
- Watanabe T, "Japanese Society for Cancer of the Colon and Rectum(JSCCR)guidelines 2014 for treatment of colorectal cancer", Int J Clin Oncol, 20, pp.207~239 (2015)
- "J Anus Rectum Colon", 2019, 175~195
- Kudo Se, "Nonpolypoid neoplastic lesions of the colorectal mucosa", Gastrointest Endosc, 68(4 Suppl), pp.S3~S47 (2008)
- IJspeert JE, "Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas", polyps, 2016, pp.65, 963~970
- Baxter NN, "Association of colonoscopy and death from colorectal cancer", Ann Intern Med, 150, pp.1~8 (2009)
- Brenner H, "Protection from right-and left-sided colorectal neoplasms after colonoscopy : population-based study", J Natl Cancer Inst, 102, pp.89~95 (2010)
- Singh H, "The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer", Gastroenterology, 139, pp.1128~1137 (2010)
- Hazewinkel Y, "Prevalence of serrated polyps and association with synchronous advanced neoplasia in screening colonoscopy", Endoscopy, 46, pp.219~224 (2014)
- Liu C, "Sessile serrated adenomas with dysplasia : morphological patterns and correlations with MLH1 immunohistochemistry", Mod Pathol, 30, pp.1728~1738 (2017)
- Tate DJ, "A standardized imaging protocol for the endoscopic prediction of dysplasia within sessile serrated polyps(with video)", Gastrointest Endosc, 87, pp.222~231 (2018)
- Kim KH, "Clinical and endoscopic characteristics of sessile serrated adenomas", polyps with dysplasia, Sci Rep, pp.2019, 9[DOI]
- Sano W, "Clinical and endoscopic evaluations of sessile serrated adenoma", polyps with cytological dysplasia, 2018, pp.33, 1454~1460
- Bettington M, "Clinicopathological and molecular features of sessile serrated adenomas with dysplasia or carcinoma", Gut, 66, pp.97~106 (2017)
- Tanaka Y, "Endoscopic and molecular characterization of colorectal sessile serrated adenoma", polyps with cytologic dysplasia, 2017, pp.86, 1131~1138
- Liu TY, "Clinicopathological features of advanced colorectal serrated lesions : a single-center study in China", J Dig Dis, 19, pp.235~241 (2018)
- Murakami T, "Endoscopic diagnosis of sessile serrated adenoma", polyp with and without dysplasia, World J Gastroenterol, pp.2018, 24[DOI]
- 김창준, "한국인 중간암의 유병률, 임상병리학적 특징과 예측인자", Intestinal research, 11(3), pp.178~183 (2013), 대한장연구학회
- Kil Woo Lee, "Microsatellite Instability Status of Interval Colorectal Cancers in a Korean Population", Gut and Liver, 10(5), pp.781~785 (2016), 거트앤리버 소화기연관학회협의회
- Boparai KS, "Hyperplastic polyposis syndrome : a pilot study for the differentiation of polyps by using high-resolution endoscopy, autofluorescence imaging, and narrow-band imaging", Gastrointest Endosc, 70, pp.947~955 (2009)
- Tadepalli US, "A morphologic analysis of sessile serrated polyps observed during routine colonoscopy(with video)", Gastrointest Endosc, 74, pp.1360~1368 (2011)
- Kimura T, "A novel pit pattern identifies the precursor of colorectal cancer derived from sessile serrated adenoma", Am J Gastroenterol, 107, pp.460~469 (2012)
- Sano W, "Prospective evaluation of the proportion of sessile serrated adenoma", polyps in endoscopically diagnosed colorectal polyps with hyperplastic features, 2015, pp.3, E354~E358
- Ponugoti P, "Prevalence of sessile serrated adenoma", polyp in hyperplastic-appearing diminutive rectosigmoid polyps, 2017, pp.85, 622~627
