Predictors of Metachronous Risk Polyps After Index Colonoscopy.
Journal
Clinical and translational gastroenterology
ISSN: 2155-384X
Titre abrégé: Clin Transl Gastroenterol
Pays: United States
ID NLM: 101532142
Informations de publication
Date de publication:
18 02 2021
18 02 2021
Historique:
received:
19
05
2020
accepted:
18
12
2020
entrez:
19
2
2021
pubmed:
20
2
2021
medline:
28
9
2021
Statut:
epublish
Résumé
Guidelines for surveillance after polypectomy are lacking in strong evidence. Our aim was to identify some precursors of colorectal cancer lesions at 3 years after polypectomy to improve stratification and surveillance programs. We included patients with high-risk lesions (HRLs), defined as advanced adenoma (AA), large serrated polyps (SPs), and multiplicity (≥3 of any adenomas/SPs). Data on age, sex, cardiovascular risk factors, pharmacological treatment, and the histological characteristics in each individual, and mutations in genes involved in the most advanced index polyp, were collected. Parameters independently associated with a metachronous HRL diagnosis were evaluated through univariate and multivariate analyses. The results are reported as odds ratios and 95% confidence intervals along with P values. A total of 537 cases (median age: 60.7 years; 66% male) were included. Dyslipidemia and smoking correlated with metachronous HRLs. Multivariate logistic regression analysis showed that the presence of multiplicity with ≥3 polyps on the index colonoscopy was significantly associated with metachronous HRL, AA, proximal AA, and ≥3 polyps at 3 years. In addition, independent predictors of metachronous proximal AA were increasing age, female sex, and the loss of expression of the MLH1 protein. Multiplicity was a strong predictor of HRLs at 3 years, although the inclusion of other clinical variables (age, sex, smoking status, and dyslipidemia) improves surveillance recommendations. Without these risk factors, the surveillance could be extended to 5 years; we propose examining the somatic expression of MHL1 in all patients.
Identifiants
pubmed: 33605613
doi: 10.14309/ctg.0000000000000304
pii: 01720094-202102000-00013
pmc: PMC7899856
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e00304Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.
Références
Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med 1992;326(10):658–62.
Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 1993;329(27):1977–81.
Rex DK, Ahnen DJ, Baron JA, et al. Serrated lesions of the colorectum: Review and recommendations from an expert panel. Am J Gastroenterol 2012;107(9):1315–29.
East JE, Atkin WS, Bateman AC, et al. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum. Gut 2017;66(7):1181–96.
Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012;366(8):687–96.
Arditi C, Peytremann-Bridevaux I, Burnand B, et al. Appropriateness of colonoscopy in Europe (EPAGE II) Screening for colorectal cancer. Endoscopy 2009;41:200–8.
He X, Hang D, Wu K, et al. Long-term risk of colorectal cancer after removal of conventional adenomas and serrated polyps. Gastroenterology 2020;158(4):852–61.e4.
Song M, Emilsson L, Bozorg SR, et al. Articles. Risk of colorectal cancer incidence and mortality after polypectomy : A Swedish record-linkage study. Lancet Gastroenterol Hepatol 2020;1253(20):1–11.
Martínez ME, Baron JA, Lieberman DA, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology 2009;136(3):832–41.
van Heijningen EB, Lansdorp-Vogelaar I, Kuipers EJ, et al. Features of adenoma and colonoscopy associated with recurrent colorectal neoplasia based on a large community-based study. Gastroenterology 2013;144(7):1410–8.
Ana BM, Mercedes AM, Adán Merino L, et al. Factors related to colorectal cancer in advanced adenomas and serrated polyps. Eur J Gastroenterol Hepatol 2018;30(11):1337–43.
Anderson JC, Butterly LF, Robinson CM, et al. Risk of metachronous high-risk adenomas and large serrated polyps in individuals with serrated polyps on index colonoscopy: Data from the New Hampshire Colonoscopy Registry. Gastroenterology 2018;154(1):117–27.e2.
Bonnington SN. Surveillance of colonic polyps: Are we getting it right? World J Gastroenterol 2016;22(6):1925.
Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: A consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012;143(3):844–57.
Jacobs ET, Ahnen DJ, Ashbeck EL, et al. Association between body mass index and colorectal neoplasia at follow-up colonoscopy: A pooling study. Am J Epidemiol 2009;169(6):657–66.
Ashbeck EL, Jacobs ET, Martinez ME, et al. Components of metabolic syndrome and metachronous colorectal neoplasia. Cancer Epidemiol Biomarkers Prev 2009;18(4):1134–43.
Flood A, Mai V, Pfeiffer R, et al. Elevated serum concentrations of insulin and glucose increase risk of recurrent colorectal adenomas. Gastroenterology 2007;133(5):1423–9.
Gupta S, Sun H, Yi S, et al. Molecular markers of carcinogenesis for risk stratification of individuals with colorectal polyps: A case-control study. Cancer Prev Res 2014;7(10):1023–34.
Berger AW, Raedler K, Langner C, et al. Genetic biopsy for prediction of surveillance intervals after endoscopic resection of colonic polyps: Results of the GENESIS study. United European Gastroenterol J 2018;6(2):290–9.
Juárez M, Egoavil C, Rodríguez-Soler M, et al. KRAS and BRAF somatic mutations in colonic polyps and the risk of metachronous neoplasia. PLoS One 2017;12(9):1–15.
Maltzman T, Knoll K, Martinez ME, et al. Ki-ras proto-oncogene mutations in sporadic colorectal adenomas: Relationship to histologic and clinical characteristics. Gastroenterology 2001;121(2):302–9.
Lochhead P, Chan AT, Nishihara R, et al. Etiologic field effect: Reappraisal of the field effect concept in cancer predisposition and progression. Mod Pathol 2015;28(1):14–29.
Valori R, Rey J-F, Atkin W, et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition—Quality assurance in endoscopy in colorectal cancer screening and diagnosis. Endoscopy 2012;44(S 03):SE88–105.
Carvajal-Carmona LG, Cazier JB, Jones AM, et al. Fine-mapping of colorectal cancer susceptibility loci at 8q23.3, 16q22.1 and 19q13.11: Refinement of association signals and use of in silico analysis to suggest functional variation and unexpected candidate target genes. Hum Mol Genet 2011;20(14):2879–88.
James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults. JAMA 2014;311(5):507.
Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech 2009;2(5–6):231–7.
Kopanos C, Tsiolkas V, Kouris A, et al. VarSome: The human genomic variant search engine. Bioinformatics 2018;35(11):1978–80.
Okanoue T, Tatsumi Y, Hattori T, et al. Expression of cytokeratins 7 and 20 in serrated adenoma and related diseases. Dig Dis Sci 2005;50(9):1741–6.
Winn B, Tavares R, Matoso A, et al. Expression of the intestinal biomarkers guanylyl cyclase C and CDX2 in poorly differentiated colorectal carcinomas. Hum Pathol 2010;41(1):123–8.
Rosty C, Clouston AD, Klein K, et al. A clinicopathological and molecular analysis of 200 traditional serrated adenomas. Mod Pathol 2014;28(3):414–27.
Bonithon-Kopp C, Piard F, Fenger C, et al. Colorectal adenoma characteristics as predictors of recurrence. Dis Colon Rectum 2004;47(3):323–33.
Leufkens A, van Oijen M, Vleggaar F, et al. Factors influencing the miss rate of polyps in a back-to-back colonoscopy study. Endoscopy 2012;44(05):470–5.
Gkolfakis P, Tziatzios G, Facciorusso A, et al. Meta-analysis indicates that add-on devices and new endoscopes reduce colonoscopy adenoma miss rate. Eur J Gastroenterol Hepatol 2018;30(12):1482–90.
Zhao S, Wang S, Pan P, et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: A systematic review and meta-analysis. Gastroenterology 2019;156(6):1661–74.e11.
Ghazi S, Lindforss U, Lindberg G, et al. Analysis of colorectal cancer morphology in relation to sex, age, location, and family history. J Gastroenterol 2012;47(6):619–34.
Hirai HW, Ching JYL, Wu JCY, et al. Risk factors for advanced colorectal neoplasms in the proximal colon in 6218 subjects undergoing complete colonoscopy. J Gastroenterol Hepatol 2019;34(1):113–9.
McCashland TM, Brand R, Lyden E, et al. Gender differences in colorectal polyps and tumors. Am J Gastroenterol 2004;96(3):882–6.
Slattery ML, Potter JD, Curtin K, et al. Estrogens reduce and withdrawal of estrogens increase risk of microsatellite instability-positive colon cancer. Cancer Res 2001;61(1):126–30.
Trayhurn P, Beattie JH. Physiological role of adipose tissue: White adipose tissue as an endocrine and secretory organ. Proc Nutr Soc 2001;60(3):329–39.
Tsoi KKF, Pau CYY, Wu WKK, et al. Cigarette smoking and the risk of colorectal cancer: A meta-analysis of prospective cohort studies. Clin Gastroenterol Hepatol 2009;7(6):682–8.e5.
Jung YS, Kim NH, Lee MY, et al. Effect of cotinine-verified change in smoking status on risk of metachronous colorectal neoplasia after polypectomy. Clin Gastroenterol Hepatol 2020;18(1):163–70.
Patel A, Williams N, Parsons N, et al. Risk factors for metachronous adenoma in the residual colon of patients undergoing curative surgery for colorectal cancer. Int J Colorectal Dis 2017;32(11):1609–16.
Lieberman DA, Weiss DG, Harford WV, et al. Five-year colon surveillance after screening colonoscopy. Gastroenterology 2007;133(4):1077–85.
Nusko G, Mansmann U, Kirchner T, et al. Risk related surveillance following colorectal polypectomy. Gut 2002;51(3):424–8.
Martínez ME, Sampliner R, Marshall JR, et al. Adenoma characteristics as risk factors for recurrence of advanced adenomas. Gastroenterology 2001;120(5):1077–83.
Rex D, Cutler C, Lemmel G, et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997;112(1):24–8.