Colorectal sessile serrated lesion with large size or synchronous neoplasm: a prospective study

Abstract

Background-Colorectal sessile serrated lesion (SSL) with synchronous neoplasm or large size are linked to higher risk of cancer, but their characteristics are unclear. Methods-We prospectively included consecutive colorectal hyperplasic polyp and SSL collected at our institution from August 2011 to August 2012. The following data were collected and analyzed: age, gender, polyp site, aggregated polyp size, history of polyp, and synchronous neoplasm. Results-We collected 437 specimens including 353 (80.8%) hyperplasic polyp and 84 (19.2%) SSL. Compared with hyperplasic polyp, SSL was independently associated with proximal colon [odds ratio (OR) 3.61, P < 0.001], larger size (OR 3.98, P < 0.001), but not history of polyp, age or gender. Large SSL (≥1 vs <1 cm) was associated with polyp site (P = 0.035) and synchronous advanced adenoma and cancer (P < 0.001). SSL with synchronous adenoma and cancer were more likely found in males (OR 1.91, P = 0.001), elderly (OR 1.02, P = 0.033), and patients with the index polyp in proximal colon (OR 1.32, P = 0.022), but not related to history of adenoma and cancer. Moreover, synchronous adenoma, SSL and cancer were independently associated with male gender (OR 1.90, P < 0.001), but surprisingly not older age, histology of index polyp (SSL vs hyperplasic polyp), index-polyp site or history of adenoma and cancer.

MLH1, BRAF and p53 – searching for significant markers to predict evolution towards adenocarcinoma in colonic sessile serrated lesions

“…Males increased prevalence of SSLs is foreseeable since CRC and all its premalignant lesions are more likely found in males [ 31 , 32 ]. Although a small study, our research confirms this prevalence, in the case-group being included 14 men and six women.…”