Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3217-3225
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3217
Clinical characteristics of sentinel polyps and their correlation with proximal colon cancer: A retrospective observational study
Man Wang, Jia-Jie Lu, Wen-Jie Kong, Xiao-Jing Kang, Feng Gao
Man Wang, Jia-Jie Lu, Wen-Jie Kong, Feng Gao, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Xiao-Jing Kang, Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Author contributions: Wang M and Gao F designed the study; Wang M acquired the data and drafted the article; Lu JJ and Kong WJ analyzed and interpreted the data; Kang XJ revised the article critically for important intellectual content. All the authors approved the version to be published.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the People’s Hospital of Xinjiang Uygur Autonomous Region.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: The protocol for this study is available in Chinese Clinical Trial Registry (ChiCTR1900021639). The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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 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/
Corresponding author: Feng Gao, PhD, Chairman, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. drxjgf@sina.com
Telephone: +86-991-8564761 Fax: +86-991-8564761
Received: April 11, 2019
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

There is still no clear conclusion about the relationship between sentinel polyps and proximal colon cancer.

Research objectives

Our main purpose was to investigate the correlation between sentinel polyps and proximal colon cancer.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.