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High-risk metachronous polyps are more frequent in patients with traditional serrated adenomas than in patients with conventional adenomas: a multicenter prospective study

 Jin Young Yoon  ;  Hyung Tae Kim  ;  Sung Pil Hong  ;  Hyun Gun Kim  ;  Jin-Oh Kim  ;  Dong-Hoon Yang  ;  Dong Il Park  ;  Seun Ja Park  ;  Hyun-Soo Kim  ;  Bora Keum  ;  Cheol Hee Park  ;  Chang Soo Eun  ;  Suck-Ho Lee  ;  Il Hyun Baek  ;  Dong Kyung Chang  ;  Tae Il Kim 
 GASTROINTESTINAL ENDOSCOPY, Vol.82(6) : 1087-1093, 2015 
Journal Title
Issue Date
Adenoma/epidemiology ; Adenoma/pathology* ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Colonic Neoplasms/epidemiology ; Colonic Neoplasms/pathology* ; Colonic Polyps/epidemiology ; Colonic Polyps/pathology* ; Colonoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary/epidemiology ; Neoplasms, Second Primary/pathology* ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology
BACKGROUND AND AIMS: Although the malignant progression of serrated polyps has been clearly documented, the malignant potential of the traditional serrated adenoma (TSA) subtype has not been established. We compared the prevalence of metachronous polyps in surveillance colonoscopies between patients with TSA and those with conventional adenomas (CAs). METHODS: Four hundred twenty patients were diagnosed with TSAs by current diagnostic criteria at 10 tertiary care university hospitals in Korea from January 2003 to December 2005; 186 patients who received surveillance colonoscopy after removal of initial polyps were enrolled. During the same time period, 372 age- and sex-matched patients diagnosed with CAs were used as a control group. RESULTS: TSA patients had a significantly higher recurrence rate of colorectal polyps compared with CA patients (66.1% vs 43.5%, respectively). TSA patients had a greater number (3 vs 2) and larger size (8.6 ± 5.7 vs 6.3 ± 5.2 mm) of recurrent polyps compared with CA patients. TSA patients also had a higher rate of CA (54.8% vs 37.9%), serrated adenoma (14.0% vs. 0.8%), and hyperplastic polyp (33.3% vs. 13.7%) recurrence compared with CA patients. TSA patients had significantly greater odds of having a recurrent high-risk polyp than CA patients (odds ratio, 2.37; 95% confidence interval, 1.55-3.63). CONCLUSIONS: In comparison with patients with CAs, patients with TSAs have a higher metachronous occurrence rate of all polyp subtypes including CAs, serrated adenomas, and hyperplastic polyps. Moreover, the presence of TSAs is an independent predictor of a high-risk polyp occurrence.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Yoon, Jin Young(윤진영)
Hong, Sung Pil(홍성필)
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