Large serrated polyps indicate a greater risk of advanced metachronous colorectal neoplasia than high-grade adenomas.

Autor:	Medawar E; Department of Medicine, University of Ottawa, Ottawa, Canada.; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada., Djinbachian R; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada.; Division of Gastroenterology, University of Montreal Hospital Centre, Montreal, Canada., Taghiakbari M; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada., Khoury T; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada., Zoughlami A; Department of Medicine, McGill University, Montreal, Canada., Zarandi-Nowroozi M; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada.; Division of Gastroenterology, University of Montreal Hospital Centre, Montreal, Canada., Safih W; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada., von Renteln D; University of Montreal Hospital Research Centre, University of Montreal, Montreal, Canada.; Division of Gastroenterology, University of Montreal Hospital Centre, Montreal, Canada.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2023 Sep 15; Vol. 11 (9), pp. E849-E858. Date of Electronic Publication: 2023 Sep 15 (Print Publication: 2023).
DOI:	10.1055/a-2124-9788
Abstrakt:	Background and study aims The risk of developing total metachronous advanced neoplasia (TMAN) in patients with index serrated lesions (SL) or adenoma with high-grade dysplasia (HGD) is unknown. We evaluated this risk in patients with either HGD, SL < 10 mm or SL ≥ 10 mm at index colonoscopy, who underwent surveillance colonoscopies. Patients and methods This retrospective cohort study evaluated all consecutive patients (n = 2477) diagnosed between 2010 and 2019 with colorectal HGD, SLs < 10 mm or SLs ≥ 10 mm. We excluded patients aged < 45 or > 75 years or those who had inflammatory bowel disease, hereditary colorectal cancer (CRC) syndromes, previous or synchronous CRC, or no follow-up colonoscopy. Descriptive variables were compared using analysis of variance or Pearson chi-squared tests. Multivariate Cox regressions were used to compare the risk of TMAN between the HGD, SL < 10 mm and SL ≥ 10 mm groups. Results Overall, 585 patients (mean age 63 years; 55% male; mean follow-up 3.67 years) were included (226 with SLs < 10 mm, 204 with SLs ≥ 10 mm, 155 with HGD). Compared with SLs < 10 mm, patients with HGD did not have a significantly different rate of TMAN (HR=0.75 [0.39-1.44]) and patients with SLs ≥ 10 mm had a higher rate of TMAN (HR=2.08 [1.38-3.15]). Compared with HGD, patients with SLs ≥ 10 mm had a higher rate of TMAN (HR=1.87 [1.04-3.36]). Conclusions The risk for TMAN was higher for patients with SLs ≥ 10 mm than with HGD or SLs < 10 mm. This risk should be considered when planning surveillance intervals for patients diagnosed with large SLs. Competing Interests: Conflict of Interest The authors would like to thank the Canadian Institutes of Health Research Canada Graduate Scholarships (Edgard Medawar) and the American College of Gastroenterology Resident Research Award (Roupen Djinbachian) for the funding of this study. Daniel von Renteln is supported by a Fonds de Recherche du Québec en Santé (FRQS) Career Development Award. Edgard Medawar, Roupen Djinbachian, Mahsa Taghiakbari, Tommy Khoury, Amine Zoughlami, Melissa Zarandi-Nowroozi, Widad Safih and Daniel von Renteln have no conflict of interest relevant to this paper to declare. Daniel von Renteln has received research funding from ERBE, Ventage, Pendopharm, Fuji, and Pentax and is a consultant and/or speaker for Boston Scientific, ERBE and Pendopharm. None of the authors have any personal or financial conflicts of interest relevant to this paper to declare. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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