Abstract
Context .- Sessile serrated adenomas/polyps (SSA/Ps) have been increasingly studied during the last 10 years. However, their detailed anatomic distribution pattern has not been studied, especially given newer (broader) criteria for the diagnosis. Objectives .- To characterize the anatomic distribution of SSA/P with and without cytologic dysplasia and to assess the demographics of these patients in a nationwide database. Design .- We retrospectively analyzed the database of Miraca Life Sciences Research Institute for a 1-year period. Patients with a diagnosis of SSA/P, SSA/P with low-grade cytologic dysplasia (SSA/P-LGD), SSA/P with high-grade cytologic dysplasia (SSA/P-HGD), or SSA/P with adenocarcinoma (SSA/P-ACA) were retrieved, and patients' age, sex, and specific anatomic location were analyzed. Results .- A total of 11 201 patients were identified, of which 10 646 (95.0%) had SSA/P, 514 (4.6%) had SSA/P-LGD, 39 (0.35%) had SSA/P-HGD, and 2 (0.018%) had SSA/P-ACA. All SSA/Ps and more advanced lesions were significantly more common in the proximal colon-SSA/P (61.2%), SSA/P-LGD (61.2%), SSA/P-HGD (80%), and SSA/P-ACA (100%)-than in either the transverse (18.8%, 17.8%, 10.0%, and 0%, respectively) or the distal (19.9%, 21.0%, 10.0%, and 0%, respectively) colon, P < .001. Sessile serrated adenoma/polyp with cytologic dysplasia was most commonly found in the ascending colon (LGD, 31.6%) and cecum (HGD, 37.5%). Advanced SSA/Ps were disproportionally more common among older women. Conclusions .- Sessile serrated adenomas/polyps with and without cytologic dysplasia and carcinoma are predominantly found in the cecum and ascending colon, whereas there is low prevalence in both the transverse and distal colon. Confirmation of previously published data regarding demographics of advanced lesions among a different cohort and including newer (broader) criteria suggests these criteria are valid.
摘要
对无蒂锯齿状腺瘤/息肉(SSA/Ps)的研究在过去的10年间明显增加。然而,它们具体解剖分布构型还没有研究,特别是当前其较新(较宽)的诊断标准被提出后。
目的:确定伴和不伴有细胞学异型性的AAS/P的解剖学分布,同时评估全球范围数据库内这些病人的临床特征。
方法:我们回顾性分析了Miraca生命科学研究所数据库1年期间的数据,收集病理诊断为SSA/P、SSA/P伴低级别细胞学异型增生(SSA/P-LGD)、SSA/P伴高级别细胞学异型增生(SSA/P-HGD)或SSA/P伴腺癌(SSA/P-ACA)的病例,同时分析这些病例的年龄、性别和解剖位置。
结果:总计11201例,其中10646例(95.0%)有SSA/P,514例(4.6%)有SSA/P-LGD,39例(0.35%)有SSA/P-HGD,2例(0.018%)有SSA/P-ACA,所有SSA/Ps和更具进展的病变明显多见于近端结肠-SSA/P (61.2%), SSA/P-LGD (61.2%), SSA/P-HGD (80%)和SSA/P-ACA (100%),高于横结肠(分别为18.8%, 17.8%, 10.0%和 0%)或远端结肠 (19.9%, 21.0%, 10.0%和0%)。无蒂锯齿状腺瘤/息肉伴细胞学异型增生最常见升结肠(LGD,31.6%)和盲肠(HGD,37.5%)。进展性SSA/Ps偏向于老年女性较常见。
结论:无蒂锯齿状腺瘤/息肉伴和不伴细胞学异型增生以及癌者主要见于盲肠和升结肠,而横结肠和远端结肠发生率低。不同研究队列中以及采用较新(较宽)诊断标准对以前的数据进行证实,表明这些诊断标准是有效的。
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