Right-Sided Adenomas of the Colon: A Risk Factor For High-Grade Dysplasia or Invasive Cancer

Yıl 2014, , 74 - 77, 01.06.2014

Ahmet Tarık Eminler Mustafa Ihsan Uslan Kader Irak Talat Ayyıldız Murat Keskin Murat Kıyıcı Selim Gürel Macit Gülten Enver Dolar Selim Giray Nak

https://doi.org/10.5505/sakaryamj.2014.75002

Öz

AIM: The aim of the study was to evaluate multiple patient and adenoma variables associated with high-grade dyplasia (HGD) and invasive carcinoma. (which were termed as "advanced pathology (AP)").MATERIALS AND METHODS: In total 6250 processes there were 1379 (22.06 %) polyps from 894 patients. We evaluated 914 polpys which we could find patholojical results.RESULTS: A total of 699 adenomas were detected from 914 polyps. We found more higher percantage of AP features at the rigt-sided adenomas than the left-sided (18.5% vs 7.1%, p: 0.002). According to the logistic regression analysis; male gender, larger or equal 2 cm diameter, villous histology and non-dimunitive gross appearance were found to be the independent risk factors for the AP features of the adenomas.CONCLUSION: In our study, similar to other studies, male gender, larger than 2 cm adenom diameter, villous component and non-dimunitive gross appearance are the independent risk factors for the AP features of any adenomas. However in contrast to most of the other studies we found higher percentage of AP features at the right-sided adenomas than the left-sided ones.

Anahtar Kelimeler

Colorectal adenomas, dysplasia, adenocarcinoma

Sağ Kolon Yerleşimli Adenomlar: High-Grade Displazi veya İnvaziv Kanser için Risk Faktörü

Öz

Amaç: Bu çalışmanın amacı high-grade displazi (HGD) ve invaziv kanser ( “ilerlemiş patoloji (İP)” olarak tanımlanmıştır) ile ilişkili multipl hasta ve adenom
karakterlerini değerlendirmektir.
Materyal ve Metod: Toplam 6250 işlem sonunda 894 hastada 1379 (% 22.06) polip mevcuttur. Biz patoloji sonuçlarına ulaşabildiğimiz 914 polipi değerlendirmeye
aldık.
Bulgular: 914 polipte toplam 699 adenom tespit edildi. A total of 699 adenomas were detected from 914 polyps. Sağ kolon yerleşimli poliplerde sola göre daha
yüksek oranda İP özellikleri bulundu (% 18.5 vs % 7.1 p: 0.002). Lojistik regresyon analizi sonucunda; erkek cinsiyet, 2 cm’e eşit ya da büyük boyut, villöz histoloji
ve non-dimünitif görünüm adenomlardaki İP özellikleri için bağımsız risk faktörleri olarak bulundu.
Sonuç: Çalışmamızda, diğer çalışmalara benzer olarak, erkek cinsiyet, 2 cm’e eşit ya da büyük boyut, villöz histoloji ve non-dimünitif görünüm adenomlardaki
İP özellikleri için bağımsız risk faktörleri olarak bulundu. Fakat diğer birçok çalışmanın aksine biz sağ kolon yerleşimli poliplerde sol taraf yerleşimli poliplere göre
daha yüksek oranda İP özellikleri bulduk.

Anahtar Kelimeler

Kolorektal adenomlar, dizplazi, adenokanser

Kaynakça

• 1. Kristjansdottir S, Jonasson JG, Cariglia N, Thjodleifsson B. Colonic adenomas found via colonoscopy: yield and risk factors for high-grade dysplasia. Digestion. 2010;82(4): 252-7
• 2. Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36: 2251-70.
• 3. Gschwantler M, Kriwanek S, Langner E, et al. High-grade dysplasia and invasive carcinoma in colorectal adenomas: a multivariate analysis of the impact of adenoma and patient characteristics. Eur J Gastroenterol Hepatol. 2002 Feb;14(2): 183-8.
• 4. Heitman SJ, Ronksley PE, Hilsden RJ, et al. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and metaanalysis. Clin Gastroenterol Hepatol 2009;7: 1272-8
• 5. Hamilton SR Aaltonen LA (eds): World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System. Lyon, IARC Press, 2000.
• 6. O'Brien MJ, Winawer SJ, Zauber AG, Gottlieb LS, Sternberg SS, Diaz B, et al. The National Polyp Study. Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology 1990;98: 371-79.
• 7. Shinya H, Wolff WI. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg 1979;190: 679-83.
• 8. Rex DK, Lehman GA, Ulbright TM, Smith JJ, Pound DC, Hawes RH. Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: influence of age, gender, and family history. Am J Gastroenterol 1993;88: 825-31.
• 9. Cappell MS. The pathophysiology, clinical presentation, and diagnosis of colon cancer and adenomatous polyps. Med Clin N Am 89 (2005) 1–42
• 10. Toll AD, Fabius D, Hyslop T. Prognostic significance of high-grade dysplasia in colorectal adenomas. Colorectal Dis. 2011 Apr;13(4):370-3
• 11. Martínez ME, Baron JA, Lieberman DA, Schatzkin A et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology. 2009;136(3):832-41
• 12. Gillespie PE, Chambers TJ, Chan KW, et al. Colonic adenomas-a colonoscopy survey. Gut 1979;20: 240-5.
• 13. Nusko G, Mansmann U, Partzsch U. Invasive carcinoma in colorectal adenomas: multivariate analysis of patient and adenoma characteristics. Endoscopy. 1997 Sep;29(7): 626-31.
• 14. Caruso ML, Di Matteo G, Giorgio P. Adenoma-carcinoma sequence in the right colon. Minerva Dietol Gastroenterol. 1989 Jan-Mar;35(1): 13-6
• 15. Lee TJ, Nickerson C, Goddard AF et al. Outcome of 12-month surveillance colonoscopy in high-risk patients in the National Health Service Bowel Cancer Screening Programme. Colorectal Dis. 2013 Aug;15(8):e435-42