Document Detail

Longitudinal outcome study of sessile serrated adenomas of the colorectum: an increased risk for subsequent right-sided colorectal carcinoma.
MedLine Citation:
PMID:  20551824     Owner:  NLM     Status:  MEDLINE    
Sessile serrated adenomas (SSAs) are associated with colorectal carcinomas (CRCs) that demonstrate high microsatellite instability (MSI-H). Currently, SSAs are managed clinically in a similar fashion to adenomatous polyps (APs). We studied the natural history of SSA by analyzing the outcome of previously undiagnosed SSAs and comparing it with that of hyperplastic polyps (HPs) and APs. All colorectal polyps diagnosed between 1980 and 2001 as HP were selected for study. Polyps identified as possible SSAs were reviewed by 3 pathologists, and the diagnosis was confirmed. Clinical follow-up was obtained for each SSA patient and matched with control HP and AP patients. In total, 1402 colorectal polyps diagnosed as HP were examined and 81 polyps in 55 patients (5.8%) were rediagnosed as SSA. Of these, 40 SSA patients had no previous history of either CRC or AP with high-grade dysplasia (HGD). Of these 40 patients, 5 developed subsequent CRCs and 1 developed AP with HGD. The incidence of subsequent CRCs was significantly higher in SSA patients than in control patients with HP (12.5% vs. 1.8%) and AP (12.5% vs. 1.8%). All of the subsequent CRCs or APs with HGD developed in the proximal colon. Four of the 5 CRCs demonstrated a high microsatellite instability phenotype. We conclude that SSAs are high-risk lesions, with 15% of the SSA patients developing subsequent CRCs or APs with HGD. This incidence is higher than that of the control HP and AP patients, and would support close endoscopic follow-up in patients harboring SSAs.
Fang-I Lu; De Wet van Niekerk; David Owen; Susan P L Tha; Dmitry A Turbin; Douglas L Webber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  34     ISSN:  1532-0979     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-29     Completed Date:  2010-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  927-34     Citation Subset:  IM    
Department of Pathology and Laboratory Medicine, University of British Columbia Faculty of Medicine, Vancouver, Canada.
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MeSH Terms
Adenocarcinoma / epidemiology,  pathology*
Adenomatous Polyps / epidemiology,  pathology*
Aged, 80 and over
Canada / epidemiology
Colonic Polyps / epidemiology,  pathology*
Colorectal Neoplasms / epidemiology,  pathology*
Disease Progression
Longitudinal Studies
Middle Aged
Neoplasms, Second Primary / epidemiology,  pathology*
Precancerous Conditions / epidemiology,  pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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