Clinicopathological features of advanced colorectal serrated lesions: A single‐center study in China

Liu, Tian Yu; Jin, Duo Chen; Khan, Samiullah; Chen, Xue; Shi, Tao; Dong, Wen; Qi, Yan Rong; Guo, Zi Xuan; Wang, Bang Mao; Cao, Hai Long

doi:10.1111/1751-2980.12589

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…In analysis of endoscopic and pathological factors associated with dysplasia/carcinoma, distal colon, large size, polypoid morphology, surface-changes, no mucus cap, adenomatous surface-patterns, and histologically complete resection was significantly associated with SSLs with dysplasia/carcinoma, particularly large size, depression and NICE type 2/3 in multivariate analysis. Similar to previous studies [8,[17][18][19][20]33,[35][36][37][38][39], SSLs with dysplasia/carcinoma occurred more frequently in the proximal colon than in distal colon (52/254 [20.5%] vs. 23/254 [9.1%]) compared with SSLs without dysplasia. However, the risk of dysplasia was signifi-cantly higher in the distal colon than in the proximal colon (23/54 [42.6%] vs. 52/200 [26.0%], p = 0.02).…”

Section: Discussionsupporting

confidence: 88%

Clinical and endoscopic characteristics of sessile serrated lesions with dysplasia/carcinoma

Jung¹,

Kim²,

Park³

et al. 2023

Korean J Intern Med

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Background/Aims: Some sessile serrated lesions (SSLs) progress into dysplasia and colorectal cancer, however, the clinical and endoscopic characteristics of SSLs with dysplasia remain to be determined. In this study, we elucidated these characteristics in SSLs with dysplasia/carcinoma, compared with those of SSLs without dysplasia. Methods: We retrospectively collected the clinical, endoscopic, and pathological data of 254 SSLs from 216 patients endoscopically resected between January 2009 and December 2020. Results: All SSLs included 179 without dysplasia and 75 with dysplasia/carcinoma, including 55 with low-grade dysplasia, 10 with high-grade dysplasia, and 10 with submucosal cancer. In clinical characteristics, SSLs with dysplasia/carcinoma were sigwww.kjim.org

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Section: Discussionsupporting

confidence: 88%

Clinical and endoscopic characteristics of sessile serrated lesions with dysplasia/carcinoma

Jung¹,

Kim²,

Park³

et al. 2023

Korean J Intern Med

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“…The trend toward increased prevalence of RSCC is probably a consequence of better screening. Although the present study found that there were more malignancies in the left‐sided colon and rectum, our previous research showed that advanced serrated lesions, a type of precancerous lesions, were more likely to occur in the right‐sided colon …”

Section: Discussioncontrasting

confidence: 85%

“…Although the present study found that there were more malignancies in the left-sided colon and rectum, our previous research showed that advanced serrated lesions, a type of precancerous lesions, were more likely to occur in the right-sided colon. 37 The rightward shift of CRC was first reported by Ottenheimer et al 38 in 1955. We also reviewed and summarized some related studies from recent decades ( Table 5).…”

Section: Discussionmentioning

confidence: 85%

Reevaluation of a rightward shift in colorectal cancer: A single‐center retrospective study in Tianjin

Chen

Liu

et al. 2019

J of Digest Diseases

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Objectives Some Western reports have shown a proximal shift in colorectal cancer (CRC), but there are few studies in China. This study aimed to provide more information for the management and screening of CRC by investigating trends in the anatomic distribution of CRC among the Chinese population in recent years. Methods A retrospective study was conducted on patients with CRC admitted to the Digestive Endoscopy Center of Tianjin Medical University General Hospital between January 2000 and December 2017. Patients were divided into a left‐sided colorectal cancer (LSCRC) group and a right‐sided colon cancer (RSCC) group. The detection rates of LSCRC and RSCC based on patients' age and sex, and on the time periods were analyzed. Results A total of 2319 cases were diagnosed with CRC among 75 183 consecutive patients. The prevalence of CRC showed a significant reduction from 2000‐2008 to 2009‐2017 (3.8% vs 2.7%, P < .001). The proportion of RSCC presented a downtrend from 2000‐2008 to 2009‐2017 (40.6% vs 37.7%, P > .05). There were slightly more RSCCs in female patients than in male patients, with no significant difference (40.9% vs 36.5%, P > .05). The proportion of RSCC in patients aged ≥50 years was similar to that in younger patients. The alarming symptoms between LSCRC and RSCC showed a significant difference (P < .05). Conclusions In the present study, the prevalence of CRC declined significantly with time. However, there did not appear to be a rightward shift in CRC among the patients in Tianjin over the past 18 years.

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“…Serrated neoplasia appears to be a universal human phenomenon; SSLs and other serrated lesions are found in many disparate populations and ethnic groups. Although most epidemiology studies of SSLs were performed in the United States or Europe, serrated polyps have been reported worldwide, in studies from Korea, 57 Japan, 58,59 China, 60,61 Australia, 62 Peru, 63 Argentina, 64 Russia, 65 Turkey, 66 India, 67 and Nigeria, 68 among other countries. In general, countries that do not screen the population for CRC, or that perform colonoscopies primarily for diagnostic purposes, report lower prevalence values for adenomatous polyps and serrated polyps.…”

Section: Epidemiologymentioning

confidence: 99%

Terminology, Molecular Features, Epidemiology, and Management of Serrated Colorectal Neoplasia

2019

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In addition to the adenoma to carcinoma sequence, colorectal carcinogenesis can occur via the serrated pathway. Studies have focused on clarification of categories and molecular features of serrated polyps, as well as endoscopic detection and risk assessment. Guidelines from the World Health Organization propose assigning serrated polyps to categories of hyperplastic polyps, traditional serrated adenomas, and sessile serrated lesions (SSLs). Traditional serrated adenomas and SSLs are precursors to colorectal cancer. The serrated pathway is characterized by mutations in RAS and RAF, disruptions to the Wnt signaling pathway, and widespread methylation of CpG islands. Epidemiology studies of serrated polyps have been hampered by inconsistencies in terminology and reporting, but the prevalence of serrated class polyps is 20%-40% in average-risk individuals; most serrated polyps detected are hyperplastic. SSLs, the most common premalignant serrated subtype, and are found in up to 15% of average-risk patients by highdetecting endoscopists. Variations in rate of endoscopic detection of serrated polyps indicate the need for careful examination, with adequate bowel preparation and sufficient withdrawal times. Risk factors for SSLs include white race, family history of colorectal cancer, smoking, and alcohol intake. Patients with serrated polyps, particularly SSLs and traditional serrated adenomas, have an increased risk of synchronous and metachronous advanced neoplasia. Surveillance guidelines vary among countries, but SSLs and proximal hyperplastic polyps require special attention in assignment of surveillance interval-especially in light of concerns regarding incomplete detection and resection.

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Clinicopathological features of advanced colorectal serrated lesions: A single‐center study in China

Abstract: ASLs are more likely to occur in the proximal colon, and mainly present as flat and sub-pedunculated types. Large ASLs are significantly associated with sACN.

Cited by 7 publications

References 48 publications

Clinical and endoscopic characteristics of sessile serrated lesions with dysplasia/carcinoma

Clinical and endoscopic characteristics of sessile serrated lesions with dysplasia/carcinoma

Reevaluation of a rightward shift in colorectal cancer: A single‐center retrospective study in Tianjin

Terminology, Molecular Features, Epidemiology, and Management of Serrated Colorectal Neoplasia

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