Observational Study
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World J Clin Oncol. Feb 24, 2024; 15(2): 290-301
Published online Feb 24, 2024. doi: 10.5306/wjco.v15.i2.290
Prevalence, risk factors, and BRAF mutation of colorectal sessile serrated lesions among Vietnamese patients
Nhu Thi Hanh Vu, Huy Minh Le, Diem Thi-Ngoc Vo, Hoang Anh Vu, Nhan Quang Le, Dung Dang Quy Ho, Duc Trong Quach
Nhu Thi Hanh Vu, Duc Trong Quach, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 700000, Viet Nam
Nhu Thi Hanh Vu, Huy Minh Le, Nhan Quang Le, Duc Trong Quach, GI Endoscopy Department, University Medical Center at Ho Chi Minh City, Ho Chi Minh 700000, Viet Nam
Huy Minh Le, Diem Thi-Ngoc Vo, Department of Histology-Embryology and Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 700000, Viet Nam
Hoang Anh Vu, Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 700000, Viet Nam
Dung Dang Quy Ho, Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh 700000, Viet Nam
Author contributions: Quach DT contributed to the study’s conception; Vu NTH, Le NQ, Le HM, Vo DTN, and Vu HA conducted data curation; Vu NTH, and Quach DT performed data analysis; Ho DDQ, Quach DT, Le NQ, and Le HM provided supervision for the study; Vu NTH, Quach DT, and Vu HA drafted the initial manuscript; Ho DDQ, Vo DTN, Quach DT, Le HM, Le NQ, and Vu HA reviewed and edited the manuscript.
Institutional review board statement: The study was approved by the Board of Ethics in Biomedical Research of the University of Medicine and Pharmacy at Ho Chi Minh City (ID number: 615/HDDD-DHYD, signed on November 19, 2021).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Duc Trong Quach, MD, PhD, Associate Professor, Senior Lecturer, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh 700000, Viet Nam. duc.qt@umc.edu.vn
Received: December 13, 2023
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
Processing time: 68 Days and 21.3 Hours
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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%.

Research conclusions

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.

Research perspectives

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.