High risk features in colorectal adenomatous polyps: A multi-institutional study.

Autor: Lee M; Columbia University Medical Center, United States of America. Electronic address: mjl2197@cumc.columbia.edu., Ko HM; Columbia University Medical Center, United States of America., Kudose S; Columbia University Medical Center, United States of America., Remotti H; Columbia University Medical Center, United States of America., Choi WT; University of California San Francisco, United States of America., Salomao MA; Mayo Clinic, United States of America., Zhao L; Brigham and Women's Hospital, Harvard Medical School, United States of America., Isidro RA; Brigham and Women's Hospital, Harvard Medical School, United States of America., Liao X; University of Rochester Medical Center, United States of America., Ettel MG; University of Rochester, United States of America., Chen IY; University of Rochester Medical Center, United States of America., Liu X; University of Rochester Medical Center, United States of America., Pai R; UPMC Presbyterian Hospital, United States of America., Alpert L; University of Chicago, United States of America., Setia N; University of Chicago, United States of America., Wu E; Rhode Island Hospital, Brown University, United States of America., Henn P; University of Colorado Anschutz Medical Campus, United States of America., Westbrook L; University of Colorado Anschutz Medical Campus, United States of America., Lagana SM; Columbia University Medical Center, United States of America.
Jazyk: angličtina
Zdroj: Annals of diagnostic pathology [Ann Diagn Pathol] 2024 Oct; Vol. 72, pp. 152323. Date of Electronic Publication: 2024 May 08.
DOI: 10.1016/j.anndiagpath.2024.152323
Abstrakt: High risk features in colorectal adenomatous polyps include size >1 cm and advanced histology: high-grade dysplasia and villous architecture. We investigated whether the diagnostic rates of advanced histology in colorectal adenomatous polyps were similar among institutions across the United States, and if not, could differences be explained by patient age, polyp size, and/or CRC rate. Nine academic institutions contributed data from three pathologists who had signed out at least 100 colorectal adenomatous polyps each from 2018 to 2019 taken from patients undergoing screening colonoscopy. For each case, we recorded patient age and sex, polyp size and location, concurrent CRC, and presence or absence of HGD and villous features. A total of 2700 polyps from 1886 patients (mean age: 61 years) were collected. One hundred twenty-four (5 %) of the 2700 polyps had advanced histology, including 35 (1 %) with HGD and 101 (4 %) with villous features. The diagnostic rate of advanced histology varied by institution from 1.7 % to 9.3 % (median: 4.3 %, standard deviation [SD]: 2.5 %). The rate of HGD ranged from 0 % to 3.3 % (median: 1 %, SD: 1.2 %), while the rate of villous architecture varied from 1 % to 8 % (median: 3.7 %, SD: 2.5 %). In a multivariate analysis, the factor most strongly associated with advanced histology was polyp size >1 cm with an odds ratio (OR) of 31.82 (95 % confidence interval [CI]: 20.52-50.25, p < 0.05). Inter-institutional differences in the rate of polyps >1 cm likely explain some of the diagnostic variance, but pathologic subjectivity may be another contributing factor.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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