Published online Feb 24, 2024. doi: 10.5306/wjco.v15.i2.290
Peer-review started: December 13, 2023
First decision: December 22, 2023
Revised: December 25, 2023
Accepted: January 12, 2024
Article in press: January 12, 2024
Published online: February 24, 2024
Sessile serrated lesions (SSLs) are precancerous colorectal lesions that should be identified and removed to prevent colorectal cancer. However, previous research in Vietnam mainly focused on the adenoma pathway, with limited information on the serrated pathway.
The reported prevalence of SSLs varies widely across studies, leading to underestimating their prevalence and biased analysis. Moreover, studies analyzing risk factors for SSLs have been limited and controversial. Furthermore, BRAF mutations may be a potential therapeutic target in serrated colorectal neoplasia.
Our study aimed to evaluate the prevalence, risk factors, and BRAF mutations of SSLs in Vietnamese patients. These findings may provide valuable insights into the prevention, early detection, treatment improvement, and surveillance approaches for SSLs in the Vietnamese population.
This is a cross-sectional study carried out on patients with lower gastrointestinal symptoms who underwent colonoscopy at the University Medical Center at Ho Chi Minh City, Vietnam. SSLs were diagnosed on histopathology according to the updated 2019 WHO classification. BRAF mutation analysis was performed using the Sanger DNA sequencing method. Univariate and multivariate logistic regression analyses were used to determine SSL-associated factors.
There were 2489 patients were included in the analysis, with a mean age of 52.1 ± 13.1 and a female-to-male ratio of 1:1.1. A total of 121 specimens from 105 patients were histopathologically confirmed to have SSLs, with a prevalence of 4.2% [95% confidence interval (CI): 3.5-5.1]. The factors significantly associated with SSLs in the multivariate model were age ≥ 40 [odds ratio (OR): 3.303; 95%CI: 1.607-6.790; P = 0.001], male sex (OR: 2.032; 95%CI: 1.204-3.429; P = 0.008), diabetes mellitus (OR: 2.721; 95%CI: 1.551-4.772; P < 0.001), and hypertension (OR: 1.650; 95%CI: 1.045-2.605; P = 0.031). The rate of BRAF mutations in SSLs was 35.5%.
We reported for the first time a prevalence of SSLs in Vietnamese patients with lower gastrointestinal symptoms. Our data revealed that age ≥ 40, male sex, diabetes mellitus, and hypertension were independent risk factors for SSLs. Additional investigations are needed to ascertain the connection between these risk factors and SSLs, especially in the Vietnamese population.
It is crucial to conduct multicenter, prospective, and follow-up studies to determine the prevalence, risk factors, and molecular characteristics of SSLs, especially in the Vietnamese population.