Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

What are the Endoscopic and Pathological Characteristics of Colorectal Polyps?

  • Bas, Bilge (Department of Gastroenterology, Ataturk State Hospital) ;
  • Dinc, Bulent (Department of Surgery, Ataturk State Hospital) ;
  • Oymaci, Erkan (Department of Gastroenterological Surgery, Izmir Bozyaka Training and Research Hospital) ;
  • Mayir, Burhan (Department of Surgery, Antalya Training and Research Hospital) ;
  • Gunduz, Umut Riza (Department of Surgery, Antalya Training and Research Hospital)
  • Published : 2015.08.03
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited low-grade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.

Keywords

References

  1. OI, Arigbabu AO, Agbakwuru AE, et al (2014). Polyp prevalence at colonoscopy among Nigerians: A prospective observational study. Niger J Clin Pract, 17, 756-62. https://doi.org/10.4103/1119-3077.144391
  2. Altinparmak E, Sezgin O, Parlak E, Altintas E (2001). Colorectal polyps 'The Yuksek Ihtisas experience'. Turk J Gastroenterol, 12, 49-52.
  3. Anwar S, White J, Hall C, et al (1999). Sporadic colorectal polyps: management options and guidelines. Scand J Gastroenterol, 34, 4-11. https://doi.org/10.1080/00365529950172754
  4. Bond JH (2000). Polyp guideline: Diagnosis, treatment, and surveillance for patients with colorectal polyps. practice parameters committee of the American college of gastroenterology. Am J Gastroenterol, 95, 3053-63. https://doi.org/10.1111/j.1572-0241.2000.03434.x
  5. Delavari A, Mardan F, Salimzadeh H, et al (2014). Characteristics of colorectal polyps and cancer; a retrospective review of colonoscopy data in Iran. Middle East J Dig Dis, 6, 144-50.
  6. Diamond SJ, Enestvedt BK, Jiang Z, et al (2011). Adenoma detection rate increases with each decade of life after 50 years of age. Gastrointest Endosc, 74, 135-40. https://doi.org/10.1016/j.gie.2011.03.1178
  7. Dolek Y, Karabulut YY, Topal F, Kursun N (2013). Evaluation of gastrointestinal polyps according to their size, localization and histopathologic types. Endoscopy Gastrointestinal, 21, 31-5.
  8. Eminler AT, Sakalli M, Irak K, et al (2011). Gastroenteroloji unitemizdeki kolonoskopik polipektomi sonuclarimiz. Akademik Gastroenteroloji Dergisi, 10, 112-5.
  9. Hodadoostan MK, Reza F, Elham M, et al (2010). Clinical and pathology characteristics of colorectal polyps in Iranian population. Asian Pac J Cancer Prev, 11, 557-60.
  10. Iravani S, Kashfi SM, Azimzadeh P, Lashkari MH (2014). Prevalence and characteristics of colorectal polyps in symptomatic and asymptomatic Iranian patients undergoing colonoscopy from 2009-2013. Asian Pac J Cancer Prev, 15, 9933-7. https://doi.org/10.7314/APJCP.2014.15.22.9933
  11. Itzkowitz SH, Potack J (2006). Colonic polyps and polyposis syndromes. In 'Sleisenger and Fordtran's Gastrointestinal and Liver Disease', Eds Feldman M, Friedman LS and Brandt LJ. Elsevier Health Sciences Press, Philedeplhia pp 2713-36.
  12. Jass JR, Sobin LH, Watanabe H (1990). World Health Organization's histological typing of intestinal tumours. A commentary on the second edition. Cancer, 66, 2162-7. https://doi.org/10.1002/1097-0142(19901115)66:10<2162::AID-CNCR2820661020>3.0.CO;2-N
  13. Karaman H, Karaman A, Erden A, et al (2013). Relationship between colonic polyp type and the neutrophil/ lymphocyte ratio as a biomarker. Asian Pac J Cancer Prev, 14, 3159-61. https://doi.org/10.7314/APJCP.2013.14.5.3159
  14. Li M, Ali SM, Umm-a-OmarahGilani S, et al (2014). Kudo's pit pattern classification for colorectal neoplasms: a metaanalysis. World J Gastroenterol, 20, 12649-56. https://doi.org/10.3748/wjg.v20.i35.12649
  15. Lieberman DA, Holub JL, Moravec MD, et al (2008). Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients. JAMA, 300, 1417-22. https://doi.org/10.1001/jama.300.12.1417
  16. Lowenfels AB, Williams JL, Holub JL, Maisonneuve P, Lieberman DA (2011). Determinants of polyp size in patients undergoing screening colonoscopy. BMC Gastroenterol, 11, 101. https://doi.org/10.1186/1471-230X-11-101
  17. O'Brien MJ, Winaver SJ, Zauber AG, et al (1990). The National Polyp Study: Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterolgy, 98, 371-9.
  18. Pendergrass CJ, Edelstein DL, Hylind LM, et al (2008). Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol, 6, 1011-5. https://doi.org/10.1016/j.cgh.2008.03.022
  19. Ransohoff DF (2009). How much does colonoscopy reduce colon cancer mortality? Ann Intern Med, 150, 50 2. https://doi.org/10.7326/0003-4819-150-1-200901060-00308
  20. Shussman N, Wexner SD (2014). Colorectal polyps and polyposis syndromes. Gastroenterol Rep (Oxf), 2, 1-15. https://doi.org/10.1093/gastro/got041
  21. Silva SM, Rosa VF, Santos AC, et al (2014). Influence of patient age and colorectal polyp size on histopathology findings. Arq Brass Cir Dig, 27, 109-13. https://doi.org/10.1590/S0102-67202014000200006
  22. Snover DC, Jass JR, Fenoglio-Preiser C, Batts KP (2005). Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept. Am J Clin Pathol, 124, 380-91. https://doi.org/10.1309/V2EPTPLJRB3FGHJL
  23. Solakoglu T, Atalay R, Koseoglu H, et al (2014). Analysis of 2222 colorectal polyps in 896 patients: A tertiary referreal hospital study. Turk J Gastroenterol, 25, 175-9. https://doi.org/10.5152/tjg.2014.5059
  24. Wang FW, Hsu PI, Chuang HY, et al (2014). Prevalence and risk factors of asymptomatic colorectal polyps in Taiwan. Gastroenterol Res Pract, 2014, 985205.
  25. Williams AR, Balasooriya BA, Day DW (1982). Polyps and cancer of the large bowel: a necropsy study in Liverpool. Gut, 23, 835-42. https://doi.org/10.1136/gut.23.10.835
  26. Winawer SJ, Zauber AG, Fletcher RH, et al (2006). Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US multi-society task force on colorectal cancer and the American cancer society. Gastroenterology, 130, 1872-85. https://doi.org/10.1053/j.gastro.2006.03.012