Clinical,endoscopic And Pathological Features Of 80 Cases Of Serrated Adenoma

Objective : To study the clinical,endoscopic and pathological features of serrated adenoma.Methods: The clinical,endoscopic and pathological data of 80 patients with serrated adenomas diagnosed by pathology from January 2017 to October 2020 in the Center for Diagnosis and Treatment of Digestive Endoscopy,Shengjing Hospital Affiliated to China Medical University were retrospectively studied.Chi-square analysis was used to compare the differences between the groups,and the characteristics of broad base serrated lesions were further discussed.Results: A total of 80 cases of serrated adenoma were detected in 73 patients,most of which were single.The male to female ratio was 1.52:1,and the mean age was(58.73±11.96)years.The clinical manifestations were varied.Lesion sites: 36(45.00%)in right colon and 44(55.00%)in left colon.Morphology: the left hemicolon was mainly of the bulge type,while the right hemicolon was mainly of the flat and lateral development type.The average diameter of the lesions was 1.69 cm,and the lesions in type IIIL of the glandular duct opening were mostly smaller than 2.0cm,while those in type IV of the glandular duct opening were mostly larger than 2.0cm.Pathological features: there were26 cases without glandular dysplasia,44 cases with low-grade intraepithelial neoplasia,6cases with high-grade intraepithelial neoplasia,and 4 cases with canceration.The diameter of lesions without glandular dysplasia and low-grade intraepithelial neoplasia was smaller than that of those without glandular dysplasia and low-grade intraepithelial neoplasia(P < 0.05).Among all the lesions,58 cases(72.50%)were diagnosed as broad-base serrated lesions.The prevalence of broad-based serrated lesions was higher in older men,with a mean diameter of 1.98 cm.Thirty-one cases(53.45%)were located in the proximal colon,19 cases were laterally developed,and 63.16%(12 cases)were located in the right colon.Among the 58 broad-base serrated lesions,43 cases(74.14%)were accompanied by dysplasia of glandular epithelium,and 4 cases(6.90%)were cancerous.Most of the glandular openings with dysplasia were IIIL type.Conclusion: serrated adenoma of colorectum,especially broad-base serrated adenoma,has its own unique characteristics,with a high proportion of cell dysplasia and the possibility of carcinogenesis.According to its clinical,endoscopic and pathological characteristics,reasonable assessment of diagnosis and treatment and follow-up interval should be made to improve the detection rate and reduce the cancer rate.