Which lesions are at higher risk of developing colorectal carcinomas: Superficially elevated serrated lesions or depressed lesions? QUAIS LESÕES APRESENTAM MAIOR RISCO DE EVOLUÇÃO PARA CARCINOMAS COLORRETAIS: AS SERRILHADAS SUPERFICIALMENTE ELEVADAS OU AS DEPRIMIDAS?

Parada A.A.; Venco F.E.; Varca-Neto M.R.; Ibrahim R.E.; Poletti P.B.; Brito H.P.; De Fatima Sare H.; Malafaia O.

Which lesions are at higher risk of developing colorectal carcinomas: Superficially elevated serrated lesions or depressed lesions? QUAIS LESÕES APRESENTAM MAIOR RISCO DE EVOLUÇÃO PARA CARCINOMAS COLORRETAIS: AS SERRILHADAS SUPERFICIALMENTE ELEVADAS OU AS DEPRIMIDAS?

Tipo

Artigo

Data de publicação

2022

Periódico

Arquivos Brasileiros de Cirurgia Digestiva

Citações (Scopus)

2

Autores

Parada A.A.
Venco F.E.
Varca-Neto M.R.
Ibrahim R.E.
Poletti P.B.
Brito H.P.
De Fatima Sare H.
Malafaia O.

Resumo

© 2022, Colegio Brasileiro de Cirurgia Digestiva. All rights reserved.BACKGROUND: There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. AIMS: The aim of this study was to compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. METHODS: This is a retrospective, cross-sectional, and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). RESULTS: In G1, 217 lesions were found in 12,653 (1.7%) colonoscopies; in G2, 558 lesions were found in 36,174 (1.5%) colonoscopies. In G1, 63.4% were women and in G2, there was no gender predominance. The average size of G1 was 16.2 mm and G2 was 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1, there were 214 (98.6%) low-grade intramucosal neoplasia and 3 (1.4%) high-grade intramucosal neoplasia. Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, we observed 88 (96.7%) low-grade intramucosal neoplasia and 3 (3.3%) high-grade intramucosal neoplasia; in G2, we observed 417 (74.7%) low-grade intramucosal neoplasia, 113 (20.3%) high-grade intramucosal neoplasia, and 28 (5.0%) submucosal adenocarcinomas (p<0.001). CONCLUSION: Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas in the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.

Assuntos Scopus

Adenoma , Carcinoma , Colonic Polyps , Colonoscopy , Colorectal Neoplasms , Cross-Sectional Studies , Female , Humans , Male , Retrospective Studies