AIM To compared individuals with serrated polyposis syndrome (SPS) to those with sessile serrated adenoma (SSA) and adenomas in the setting of endoscopists with high adenoma detection rates at a secondary and tertiary...AIM To compared individuals with serrated polyposis syndrome (SPS) to those with sessile serrated adenoma (SSA) and adenomas in the setting of endoscopists with high adenoma detection rates at a secondary and tertiary academic centre.METHODS Retrospectively we collated the clinical,endoscopic and histological features of all patients with SPS at St Vincent's public and private hospital in the last 3 years.Patients were identified by searching through 2 pathology databases.Variables explored included smoking status,symptoms,and family history of concurrent colorectal cancer,number and location of polyps.Patients with SPS were matched to two cohorts (1) patients with SSA not meeting World Health Organization (WHO) criteria for SPS over 3 years; and (2) patients with exclusively adenomas.The control cases were also matched according to gender and endoscopist.Adenoma detection rates ranged from 25% to 40%.RESULTS Forty patients with SPS were identified and matched with 40 patients in each control group.In total 15452 colonoscopies were performed over the study period which amounts to a prevalence of 1: 384 patients (0.26%) with SPS.Fourteen patients (35%) required more than 1 year to accumulate enough polyps to reach WHO criteria for SPS.The diagnosis of SPS was largely incidental and 5% SPS patients were diagnosed with colorectal cancer over 3 years.The chance of detecting a meta-synchronous adenoma was similar in those with SPS(42%) and those with SSA(55%),P = 0.49.The majority of patients(75%) meeting criteria for SPS were women.The mean age of those with SPS (45 years) was significantly lower than both cohorts with SSA(57 years) and adenomas(63 years),P = 0.01.On univariate analysis cigarette exposure,firstdegree family history of colorectal cancer and a high BMI weren't significantly more associated with SPS compared to patients with SSA or patients with adenomas.However,patients with SPS (97%) and patients with SSAs not meeting SPS criteria(98%) were significantly more likely to be Caucasian compared to patient展开更多
Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointe...Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointestinal familial polyposis syndromes with potential malignant transformation is performed.In addition,a guide for screening and surveillance was synthesized and a distribution of gene mutations according to the specific syndromes and geographic distribution was included.The following inherited polyposes syndromes were analyzed: familial adenomatous polyposis,the hamartomatous familial polyposes(Juvenile polyposis,Peutz-Jeghers syndrome,Cowden syndrome,BannayanRiley-Ruvalcaba syndrome,hereditary mixed polyposis syndrome,Gorlin syndrome,Birt-Hogg-Dube syndrome,neurofibromatosis type Ⅰand multiple endocrine neoplasia syndrome 2B),Li-Fraumeni syndrome,and MUTYHassociated adenomatous polyposis.For proper medical care,subspecialization of gastroenterologists,pathologists,and genticists in the field of familial diseases should be introduced in the medical curriculum.展开更多
文摘AIM To compared individuals with serrated polyposis syndrome (SPS) to those with sessile serrated adenoma (SSA) and adenomas in the setting of endoscopists with high adenoma detection rates at a secondary and tertiary academic centre.METHODS Retrospectively we collated the clinical,endoscopic and histological features of all patients with SPS at St Vincent's public and private hospital in the last 3 years.Patients were identified by searching through 2 pathology databases.Variables explored included smoking status,symptoms,and family history of concurrent colorectal cancer,number and location of polyps.Patients with SPS were matched to two cohorts (1) patients with SSA not meeting World Health Organization (WHO) criteria for SPS over 3 years; and (2) patients with exclusively adenomas.The control cases were also matched according to gender and endoscopist.Adenoma detection rates ranged from 25% to 40%.RESULTS Forty patients with SPS were identified and matched with 40 patients in each control group.In total 15452 colonoscopies were performed over the study period which amounts to a prevalence of 1: 384 patients (0.26%) with SPS.Fourteen patients (35%) required more than 1 year to accumulate enough polyps to reach WHO criteria for SPS.The diagnosis of SPS was largely incidental and 5% SPS patients were diagnosed with colorectal cancer over 3 years.The chance of detecting a meta-synchronous adenoma was similar in those with SPS(42%) and those with SSA(55%),P = 0.49.The majority of patients(75%) meeting criteria for SPS were women.The mean age of those with SPS (45 years) was significantly lower than both cohorts with SSA(57 years) and adenomas(63 years),P = 0.01.On univariate analysis cigarette exposure,firstdegree family history of colorectal cancer and a high BMI weren't significantly more associated with SPS compared to patients with SSA or patients with adenomas.However,patients with SPS (97%) and patients with SSAs not meeting SPS criteria(98%) were significantly more likely to be Caucasian compared to patient
基金Supported by The University of Medicine and Pharmacy of Tirgu-Mures,Romania,team research projects frame:UMFTGMPO-CC-02-F01,No.19/2014
文摘Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointestinal familial polyposis syndromes with potential malignant transformation is performed.In addition,a guide for screening and surveillance was synthesized and a distribution of gene mutations according to the specific syndromes and geographic distribution was included.The following inherited polyposes syndromes were analyzed: familial adenomatous polyposis,the hamartomatous familial polyposes(Juvenile polyposis,Peutz-Jeghers syndrome,Cowden syndrome,BannayanRiley-Ruvalcaba syndrome,hereditary mixed polyposis syndrome,Gorlin syndrome,Birt-Hogg-Dube syndrome,neurofibromatosis type Ⅰand multiple endocrine neoplasia syndrome 2B),Li-Fraumeni syndrome,and MUTYHassociated adenomatous polyposis.For proper medical care,subspecialization of gastroenterologists,pathologists,and genticists in the field of familial diseases should be introduced in the medical curriculum.
