Individuals With Sessile Serrated Polyps Express an Aggressive Colorectal Phenotype

Abstract

Individuals who coexpress sessile serrated polyps and conventional adenomas have an aggressive colorectal phenotype. They harbor larger sessile serrated polyps and more numerous and advanced adenomas than individuals with only sessile serrated polyps or adenomas. Synchronous colorectal cancers were found exclusively in cohorts with sessile serrated polyps. Individuals with sessile serrated polyps, especially with coexistent conventional adenomas, appear to be a high-risk group, which needs to be accounted for when calculating postpolypectomy surveillance intervals.

Serrated Polyps and the Risk of Synchronous Colorectal Advanced Neoplasia: A Systematic Review and Meta-Analysis

“…Th e majority of abstracts were excluded, as they were not relevant to the search topic. A total of 68 English language abstracts that involved human subjects were retrieved, and 28 potentially relevant studies were reviewed ( 10,(11)(12)(13). Aft er exclusion of 15 studies that did not report the information of interest ( 12,21,(23)(24)(25)(28)(29)(30)32,33,(35)(36)(37)(38)(39) and 4 studies that had insuffi cient data for meta-analysis ( 13,22,31,41 ), our fi nal analysis included nine studies published between 2009 and 2014.…”

Long-term risk of colorectal cancer in individuals with serrated polyps

“…Thus, individuals with large serrated polyps appear prone to develop other serrated and adenomatous polyps, suggesting a ‘serrated environment’ in the colorectum which may be a driving force in both the adenoma–carcinoma pathway and the serrated pathway. Indeed, individuals with both serrated polyps and adenomas have been found to have larger serrated polyps, and larger and more advanced adenomas compared with individuals with only one kind of polyp 18. However, when we adjusted for characteristics of concomitant adenomas, a large serrated polyp was an independent risk factor for CRC.…”

Outcomes of a 5-year follow-up of patients with sessile serrated adenomas

“…High-grade dysplasia was present in 12% and 10% of APs respectively on initial and subsequent colonoscopies. Patients with concomitant SSAs and APs are more likely to harbor larger and more aggressive phenotypes of both polyps [32,33]. One patient (5%) of the 22 patients who underwent subsequent colonoscopy would develop CRC from a villous adenoma in the sigmoid colon.…”