Serrated Polyps in Inflammatory Bowel Disease Indicate a Similar Risk of Metachronous Colorectal Neoplasia as in the General Population.

Autor: Medawar E; Department of Medicine, University of Ottawa, Ottawa, Canada.; University of Montreal Hospital Research Center (CRCHUM), 900 Saint-Denis St., Montreal, QC, H2X 0A9, Canada., Djinbachian R; University of Montreal Hospital Research Center (CRCHUM), 900 Saint-Denis St., Montreal, QC, H2X 0A9, Canada.; Division of Gastroenterology, Department of Medicine, University of Montreal Hospital Center, Montreal, Canada., Crainic IP; University of Montreal Hospital Research Center (CRCHUM), 900 Saint-Denis St., Montreal, QC, H2X 0A9, Canada., Safih W; University of Montreal Hospital Research Center (CRCHUM), 900 Saint-Denis St., Montreal, QC, H2X 0A9, Canada., Battat R; University of Montreal Hospital Research Center (CRCHUM), 900 Saint-Denis St., Montreal, QC, H2X 0A9, Canada.; Division of Gastroenterology, Department of Medicine, University of Montreal Hospital Center, Montreal, Canada., Mccurdy J; Division of Gastroenterology and Hepatology, Faculty of Medicine, University of Ottawa, Ottawa, Canada., Lakatos PL; Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Center, Montreal, Canada.; First Department of Medicine, Semmelweis University, Budapest, Hungary., von Renteln D; University of Montreal Hospital Research Center (CRCHUM), 900 Saint-Denis St., Montreal, QC, H2X 0A9, Canada. danielrenteln@gmail.com.; Division of Gastroenterology, Department of Medicine, University of Montreal Hospital Center, Montreal, Canada. danielrenteln@gmail.com.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2024 Jul; Vol. 69 (7), pp. 2595-2610. Date of Electronic Publication: 2024 May 03.
DOI: 10.1007/s10620-024-08456-z
Abstrakt: Background: The risk of metachronous advanced neoplasia after diagnosing serrated polyps in patients with IBD is poorly understood.
Methods: A retrospective multicenter cohort study was conducted between 2010 and 2019 at three tertiary centers in Montreal, Canada. From pathology databases, we identified 1587 consecutive patients with serrated polyps (sessile serrated lesion, traditional serrated adenoma, or serrated epithelial change). We included patients aged 45-74 and excluded patients with polyposis, colorectal cancer, or no follow-up. The primary outcome was the risk of metachronous advanced neoplasia (advanced adenoma, advanced serrated lesion, or colorectal cancer) after index serrated polyp, comparing patients with and without IBD.
Results: 477 patients with serrated polyps were eligible (mean age 61 years): 37 with IBD, totaling 45 serrated polyps and 440 without IBD, totaling 586 serrated polyps. The median follow-up was 3.4 years. There was no difference in metachronous advanced neoplasia (HR 0.77, 95% CI 0.32-1.84), metachronous advanced adenoma (HR 0.54, 95% CI 0.11-2.67), and metachronous advanced serrated lesion (HR 0.76, 95% CI 0.26-2.18) risk. When comparing serrated polyps in mucosa involved or uninvolved with IBD, both groups had similar intervals from IBD to serrated polyp diagnosis (p > 0.05), maximal therapies (p > 0.05), mucosal inflammation, inflammatory markers, and fecal calprotectin (p > 0.05).
Conclusion: The risk of metachronous advanced neoplasia after serrated polyp detection was similar in patients with and without IBD. Serrated polyps in IBD occurred independently of inflammation. This helps inform surveillance intervals for patients with IBD diagnosed with serrated polyps.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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