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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(03): E448-E455
DOI: 10.1055/a-2246-0820
Original article

Verification of the increase in concomitant dysplasia and cancer with the size of sessile serrated lesions

Daisuke Ohki 
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Yosuke Tsuji
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
2   Next-Generation Endoscopic Computer Vision, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan (Ringgold ID: RIN13143)
,
Hiroyuki Hisada
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Hideki Nakagawa
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Satoru Mizutani
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Kaori Oshio
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Junichi Sato
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Dai Kubota
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Rina Cho
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Yuko Miura
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Hiroya Mizutani
2   Next-Generation Endoscopic Computer Vision, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan (Ringgold ID: RIN13143)
,
Yoshiki Sakaguchi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Yu Takahashi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Seiichi Yakabi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Naomi Kakushima
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Nobutake Yamamichi
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
,
Tetsuo Ushiku
3   Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Mitsuhiro Fujishiro 
1   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Ringgold ID: RIN13143)
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Abstract

Background and study aims This study aimed to evaluate the relationship between sessile serrated lesion (SSL) size and the comorbidity rate of SSL with dysplasia (SSLD) and cancer in SSL (SSL-cancer).

Patients and methods This retrospective, single-center analysis identified SSL cases that underwent endoscopic resection between January 2015 and December 2022. The prevalence of SSL, SSLD, and SSL-cancer and their annual trends were assessed. The tumor diameter was stratified as 0 to 5 mm, 6 to 9 mm, 10 to 19 mm, and ≥ 20 mm in size. Furthermore, the frequency of SSL-D/SSL-cancer was determined in each group.

Results The prevalence of SSL was 2.9% (1328/45799). This prevalence was 1.8% (112/6192) in 2015 and 4.2% (230/5500) in 2022, indicating an increasing trend over time. A total of 1825 lesions were assessed: 1751 (96.0%), 55 (3.0%), 14 (0.8%), and 5 (0.3%) of lesions were SSL, SSL with low-grade dysplasia, SSL with high-grade dysplasia and SSL-cancer, respectively. Stratifying the SSLs by size: 0 to 5 mm, 5 to 9 mm, 10 to 19 mm, and ≥ 20 mm, SSLD and SSL-cancer rates were 2.3% (10/429), 2.4% (16/674), 5.3% (31/584), and 11.8% (16/136), respectively. SSLD and SSL-cancer were observed in 2.4% (26/1103) of small SSLs < 10 mm.

Conclusions In cases of SSL, the rate of SSLD and SSL-cancer increased as the lesion diameter increased. A certain rate of SSLD and SSL-cancer was observed even in small SSLs less than 5mm.

Keywords

Endoscopy Upper GI Tract - Endoscopic resection (ESD, EMRc, ...) - Endoscopy Lower GI Tract - Polyps / adenomas / ... - Colorectal cancer

Supplementary Material



Publication History

Received: 21 September 2023

Accepted after revision: 08 January 2024

Accepted Manuscript online:
15 January 2024

Article published online:
28 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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