Prevalence and Anatomic Distribution of Serrated and Adenomatous Lesions in Patients with Inflammatory Bowel Disease

Abstract

Background. Sessile serrated adenomas/polyps (SSA/Ps) and traditional serrated adenomas (TSAs) have not been well characterized in patients with inflammatory bowel disease (IBD). This study assesses the prevalence and anatomic distribution of SSA/Ps, TSAs, and conventional adenomas/dysplasia (Ad/Ds) in IBD patients. Methods. IBD patients with serrated, adenomatous, or hyperplastic lesions between 2005 and 2009 were identified in the regional tertiary-care hospital database. Clinicopathological information was reviewed and the histology of biopsies was reevaluated. Results. Ninety-six Ad/Ds, 25 SSA/Ps, and 4 TSAs were identified in 83 patients. Compared to Ad/Ds, serrated lesions were more prevalent in females (p = 0.046). The prevalence of Ad/Ds was 4.95%, SSA/Ps was 1.39%, and TSAs was 0.31%. No relationship was identified between lesion type and IBD type. Comparing all IBD patients, the distribution of lesion types was significantly different (p = 0.02) with Ad/Ds more common distally, SSA/Ps more common proximally, and TSAs evenly distributed. Among Crohn's disease (CD) patients, a similar distribution difference was noted (p < 0.001). However, ulcerative colitis (UC) patients had a uniform distribution of lesion types (p = 0.320). Conclusions. IBD patients have a lower prevalence of premalignant lesions compared to the general population, and the anatomic distribution of lesions differed between CD and UC patients. These findings may indicate an interaction between lesion and IBD pathogenesis with potential clinical implications.

Revisiting the distinct histomorphologic features of inflammatory bowel disease–associated neoplastic precursor lesions in the SCENIC and post–DALM Era

“…The other terminology coexisting in recent literature, 'serrated epithelial change (SEC)' [24,25], is still poorly define. On the other hand, the typical SSAs/SSLs are also seen in IBD patients, with a similar incidence and distribution pattern as seen in general population [26][27][28].…”

Morphological Classification of Corrupted Colonic Crypts in Ulcerative Colitis

“…The same crypt replacement by dysplastic cells may apply to serrated adenomas and microtubular adenomas, inasmuch as CCC with serrated and microtubular configurations lined by normal epithelium occurs in patients with UC (cfr. Figure 3) (29)(30)(31)(32)(33).…”

Non‐conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum

“…The IBD‐associated serrated dysplasias have similar clinicopathological features as their respective sporadic counterparts (Figure 10B). 91,96–100 However, among seven gastrointestinal pathologists, the overall interobserver agreement rate for SSL‐like and serrated dysplasia not otherwise specified in IBD patients was reported to be intermediate (≥60% agreement), whereas the agreement rate for TSA‐like dysplasia was the lowest (<50% agreement) 91,95 . In a recent study that evaluated a variety of immunohistochemical and molecular markers, 7% of serrated dysplasias were the only dysplastic lesions positive for BRAF 101 .…”