Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2016; 22(45): 10038-10044
Published online Dec 7, 2016. doi: 10.3748/wjg.v22.i45.10038
Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients
Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Yu-Jie Zhang, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang
Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China
Yu-Jie Zhang, Department of Pathology, General Hospital, Tianjin Medical University, Tianjin 300052, China
Author contributions: Cao HL and Dong WX contributed equally to this work; Cao HL, Dong WX, Xu MQ, Zhang YJ, Wang SN and Piao MY were involved in the data collection and analysis; Cao HL, Dong WX and Xu MQ were involved in writing the manuscript; Cao HL, Zhang YJ, Piao MY, Cao XC and Wang BM were involved in the study design and the critical review of the manuscript; Cao HL and Wang BM were involved in the critical revision of the manuscript; and all authors who contributed to the design and writing of the paper agreed with the final version and the content of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81300272, No. 81470796 (to Cao HL) and No. 81570478 (to Wang BM).
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of General Hospital, Tianjin Medical University.
Informed consent statement: Informed consent for esophagogastroduodenoscopy and colonoscopy was obtained from all of the participants before the procedure.
Conflict-of-interest statement: The authors have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Heping District 154 Anshan Road, Tianjin 300052, China. tjmughgi@hotmail.com
Telephone: +86-22-60362608 Fax: +86-22-27813550
Received: June 22, 2016
Peer-review started: June 24, 2016
First decision: September 20, 2016
Revised: November 3, 2016
Accepted: November 14, 2016
Article in press: November 16, 2016
Published online: December 7, 2016
Processing time: 167 Days and 1.9 Hours
Abstract
AIM

To analyse the clinical features of patients with the serrated lesions in the upper gastrointestinal tract (UPGI) tract.

METHODS

Patients who underwent routine esophagogastroduodenoscopy (EGD) at the Digestive Endoscopy Centre of General Hospital, Tianjin Medical University between January 2011 and December 2015 were consecutively recruited. Patients with UPGI serrated lesions were consecutively identified. The patients’ demographics and histopathology were recorded. The colorectal findings for patients who underwent colonoscopy simultaneously or within six months were also extracted from the colonoscopy database. In addition, we analysed differences in colorectal neoplasia detection between the study patients and randomly selected patients matched for age and gender who did not exhibit serrated lesions and who also underwent colonoscopy in the same period.

RESULTS

A total of 21 patients out of 98746 patients (0.02%) who underwent EGD were confirmed to have serrated lesions with predominantly crenated, sawtooth-like configurations. The mean age of the 21 patients was (55.3 ± 17.2) years, and 11 patients were male (52.4%). In terms of the locations of the serrated lesions, 17 were found in the stomach (including 3 in the cardia, 9 in the corpus and 5 in the antrum), 3 were found in the duodenum, and 1 was found in the esophagus. Serrated lesions were found in different mucosal lesions, with 14 lesions were detected in polyps (8 hyperplastic polyps and 6 serrated adenomas with low grade dysplasia), 3 detected in Ménétrier gastropathy, 3 detected in an area of inflammation or ulcer, and 1 detected in the intramucosal carcinoma of the duodenum. In addition, colonoscopy data were available for 18 patients, and a significantly higher colorectal adenoma detection rate was observed in the UPGI serrated lesions group than in the randomly selected age- and gender-matched group without serrated lesions who also underwent colonoscopy in the same period (38.9% vs 11.1%, OR = 5.091, 95%CI: 1.534-16.890, P = 0.010). The detection rate of advanced adenoma was also higher in the UPGI serrated lesions group (22.2% vs 4.2%, OR = 6.571, 95%CI: 1.322-32.660, P = 0.028).

CONCLUSION

Serrated lesions in the UPGI were detected in various mucosal lesions with different pathological morphologies. Moreover colonoscopy is recommended for the detection of concurrent colorectal adenoma for these patients.

Keywords: Clinical features; Upper gastrointestinal tract; Serrated lesions; Colorectal adenoma; Colorectal cancer

Core tip: In this retrospective study, the clinical features of the serrated lesions in the upper gastrointestinal tract (UPGI) were analysed. We found that serrated lesions in the UPGI occurred can be found in different mucosal lesions. Furthermore, a significantly higher colorectal adenoma detection rate was observed in the UPGI serrated lesions group than in the randomly selected age- and gender-matched group from our colonoscopy database, and the detection rate of advanced adenoma was also higher in the UPGI serrated group. Therefore, colonoscopy is recommended for the detection of concurrent colorectal adenoma in patients with UPGI serrated lesions.