Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3217
Peer-review started: April 12, 2019
First decision: August 1, 2019
Revised: August 23, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 26, 2019
Processing time: 198 Days and 12.5 Hours
Colorectal cancer is a common malignant tumor of the digestive tract. In recent years, the incidence of colorectal cancer has increased with the improvement of people's living standards. The relationship between sentinel polyps (rectal polyps with proximal colon cancer) and proximal colon cancer has also received extensive attention.
There is still no clear conclusion about the relationship between sentinel polyps and proximal colon cancer.
Our main purpose was to investigate the correlation between sentinel polyps and proximal colon cancer.
A retrospective analysis of 2587 patients with rectal polyps from January 2006 to December 2017 was performed. According to whether they had proximal colon carcinoma, the patients were divided into either a sentinel polyp group or a pure rectal polyp group. The endoscopic characteristics, clinical and pathological features, treatment, and prognosis of the two groups were compared.
The sentinel polyps group had a higher average age, and the positivity rates of anemia, stool occult blood, and tumor markers of the sentinel polyp group were also significantly higher than those in the rectal polyp group (P < 0.01). The majority of the patients in the sentinel polyp group had multiple polyps, large polyps, adenomatous polyps, or sessile polyps (P < 0.01). In the pure rectal polyp group, 2203 patients underwent endoscopic treatment, and all of them were cured and discharged. In the sentinel polyp group, 65 patients underwent radical operation, and 61 patients received endoscopic submucosal dissection or endoscopic mucosal resection. A total of 63.16% of patients experienced remission without tumor recurrence or metastasis, 33.33% experienced tumor regression or improved symptoms, and the other 3.51% died.
If there are multiple, sessile, and adenomatous rectal polyps with a maximum diameter > 1 cm, the possibility of polyp or proximal colon cancer should be closely monitored and a whole-colon examination should be performed.
Although the relationship between sentinel polyps and proximal colon cancer has received widespread attention, there are still no clear conclusions. This study shows that sentinel polyps are closely related to proximal colon cancer, and the characteristics of sentinel polyps provide a direction for future research on colon cancer and have clear guiding significance.