Risk of total metachronous advanced neoplasia at surveillance colonoscopy after detection of serrated lesions: a matched case-cohort study

被引：0

作者：

Djinbachian, Roupen ^{[1
,2
]}

Lafontaine, Marie-Lyssa ^{[3
,4
]}

Anderson, Joseph C. C. ^{[5
,6
]}

Pohl, Heiko ^{[5
,6
]}

Dufault, Talia ^{[3
,4
]}

Boivin, Michel ^{[1
,2
]}

Bouin, Mickael ^{[1
,2
]}

von Renteln, Daniel ^{[1
,2
,7
]}

机构：

[1] Montreal Univ Hosp Ctr CHUM, Div Gastroenterol, Montreal, PQ, Canada

[2] Montreal Univ Hosp Res Ctr CRCHUM, 900 Rue St Denis, Montreal, PQ H2X 0A9, Canada

[3] Univ Montreal, Fac Med, Montreal, PQ, Canada

[4] Montreal Univ Hosp Res Ctr CRCHUM, Montreal, PQ, Canada

[5] Dartmouth Geisel Sch Med, Hanover, NH USA

[6] VA Med Ctr, Div Gastroenterol, White River Jct, VT USA

[7] Montreal Univ Hosp Ctr CHUM, Dept Med, Div Gastroenterol, 900 Rue St Denis, Montreal, PQ H2X 0A9, Canada

来源：

ENDOSCOPY | 2023年

关键词：

SOCIETY TASK-FORCE; COLORECTAL-CANCER; CONSENSUS UPDATE; POLYPS; POLYPECTOMY; GUIDELINES; ADENOMAS; RECOMMENDATIONS; INDIVIDUALS; PREVENTION;

D O I：

暂无

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Serrated lesions are potential colorectal cancer precursors. This study evaluated the presence of total metachronous advanced neoplasia (T-MAN) at follow-up in patients with index serrated lesions compared with a matched cohort without serrated lesions.Methods Patients aged 45-74 years with serrated lesions were matched 2:1 by sex, age, synchronous polyps, and timing of index colonoscopy, to patients without serrated lesions. The primary outcome was T-MAN (advanced adenoma or high-risk serrated lesion) at follow-up. Secondary outcomes included presence of T-MAN stratified by synchronous polyps and serrated lesion characteristics.Results 1425 patients were included (475 patients, 642 serrated lesions; 950 controls; median follow-up 2.9 versus 3.6 years). Patients with serrated lesions had greater risk of T-MAN than those without (hazard ratio [HR] 6.1, 95 %CI 3.9-9.6). Patients with serrated lesions and high-risk adenoma (HRA) had higher risk of T-MAN than those with HRA alone (HR 2.6, 95% CI 1.4-4.7); similarly, patients with serrated lesions plus low-risk adenoma (LRA) had higher risk than those with LRA alone (HR 7.0, 95 % CI 2.8-18 .4), as did patients with serrated lesions without adenoma compared with no adenoma (HR 14.9, 95 % CI 6.5-34.0). Presence of proximal sessile serrated lesion (SSL; HR 9.3, 95% CI 5.4-15.9), large SSL (HR 17.8, 95 %CI 7.4-43.3), and proximal large SSL (HR 25.0, 95 %CI 8.8-71.3 ), but not distal SSL, were associated with greater risk for T-MAN. Conclusion Patients with serrated lesions had higher risk for T-MAN regardless of synchronous adenomas. Patients with serrated lesions and HRA, and those with large or proximal SSLs, were at greatest risk.

引用

页数：9

共 29 条

[1] Risk of Metachronous High-Risk Adenomas and Large Serrated Polyps in Individuals With Serrated Polyps on Index Colonoscopy: Data From the New Hampshire Colonoscopy Registry [J].