The Presence of Large Serrated Polyps Increases Risk for Colorectal Cancer.
Summary of "The Presence of Large Serrated Polyps Increases Risk for Colorectal Cancer."
BACKGROUND &
AIMS:
: There is evidence that serrated polyps (serrated adenomas and hyperplastic polyps) have different malignant potential than traditional adenomas. We used a colonoscopy database to determine the association between the presence of serrated colorectal polyps and colorectal neoplasia.
METHODS:
: We performed a multicenter observational study of 10,199 subjects who underwent first-time colonoscopies. Data collected on study subjects included age and sex and the location, size, and histology of polyps or tumors found at colonoscopy. Serrated polyps were defined as those diagnosed by the pathologists in the participating hospitals as a serrated lesion (a lesion given the term of "classical hyperplastic polyp", "traditional serrated adenoma", "sessile serrated adenoma", or "mixed serrated polyp"). Large serrated polyps (LSPs) were defined as those >/= 10 mm.
RESULTS:
: There were 1573 patients (15.4%) with advanced neoplasia, 708 patients (6.9%) with colorectal cancer (CRC), and 140 patients (1.4%) with LSPs in our cohort. Multivariate analysis associated the presence of LSPs with advanced neoplasia (odds ratio [OR]=4.01; 95% confidence interval [CI]: 2.83-5.69) and CRC (OR=3.34; 95%
CI:
2.16-5.03). The presence of LSPs was the greatest risk factor for CRC, particularly for proximal CRC (OR=4.79; 95%
CI:
2.54-8.42). Proximal and protruded LSPs were the highest risk factors for proximal CRC (OR=5.36; 95%
CI:
2.40-10.8 and OR=9.00; 95%
CI:
2.75-19.2, respectively).
CONCLUSIONS:
: The presence of LSPs is a risk factor for CRC-particularly CRC of the proximal colon.
Affiliation
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Journal Details
This article was published in the following journal.
Name: Gastroenterology
ISSN: 1528-0012
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20643134
- DOI: http://dx.doi.org/10.1053/j.gastro.2010.07.011
Medical and Biotech [MESH] Definitions
Colorectal Neoplasms
Tumors or cancer of the COLON or the RECTUM or both. Risk factors for colorectal cancer include chronic ULCERATIVE COLITIS; FAMILIAL POLYPOSIS COLI; exposure to ASBESTOS; and irradiation of the CERVIX UTERI.
Colorectal Neoplasms, Hereditary Nonpolyposis
A group of autosomal-dominant inherited diseases in which COLON CANCER arises in discrete adenomas. Unlike FAMILIAL POLYPOSIS COLI with hundreds of polyps, hereditary nonpolyposis colorectal neoplasms occur much later, in the fourth and fifth decades. HNPCC has been associated with germline mutations in mismatch repair (MMR) genes. It has been subdivided into Lynch syndrome I or site-specific colonic cancer, and LYNCH SYNDROME II which includes extracolonic cancer.
Adenomatous Polyposis Coli
A polyposis syndrome due to an autosomal dominant mutation of the APC genes (GENES, APC) on CHROMOSOME 5. The syndrome is characterized by the development of hundreds of ADENOMATOUS POLYPS in the COLON and RECTUM of affected individuals by early adulthood. The lifetime risk of colorectal cancer in these patients reaches 100 percent by age 60.
Genes, Mcc
Tumor suppressor genes located in the 5q21 region on the long arm of human chromosome 5. The mutation of these genes is associated with the formation of colorectal cancer (MCC stands for mutated in colorectal cancer).
Genes, Dcc
Tumor suppressor genes located in the 18q21-qter region of human chromosome 18. The absence of these genes is associated with the formation of colorectal cancer (DCC stands for deleted in colorectal cancer). The products of these genes show significant homology to neural cell adhesion molecules and other related cell surface glycoproteins.
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