Paneth Cell in Colorectal Adenoma and Sessile Serrated Polyp: A Comparative Study
Xiuli Liu. Cleveland Clinic, Cleveland
Background: Few studies from Japan reported the prevalence and clinicopathologic features of Paneth cell-containing colorectal adenomas. Paneth cell differentiation has not been studied in sessile serrated polyp (SSP). This study aims to determine the prevalence of Paneth cell in colorectal adenoma and SSP, and histologic features associated with Paneth cell differentiation in these lesions.
Design: One-hundred seventy three consecutively diagnosed colorectal adenomas from 119 patients (61 males and 58 females) and 104 consecutively diagnosed SSPs from 92 patients (41 males and 51 females) were reviewed. The prevalence of Paneth cells in adenomas and SSPs was determined and correlated with patient demographics and lesion characteristics. In addition, the prevalence of Paneth cell in the mucosa adjacent to SSPs was also assessed.
Results: SSP was likely to be right-sided than colorectal adenoma [76/104 (73.1%) vs. 95/173 (54.9%), p=0.003)]. Age and gender were not different between these two groups (61.0±9.2 vs 63.1±11.4 yrs, p=0.16; 44.5% patients being male in SSP group vs 51.3% in adenoma group, p=0.404). Thirty-one adenomas (17.9%) from 24 (20.2%) patients harbored Paneth cells. Patient age and adenoma size were not different between Paneth cell-containg adenomas and non-Paneth cell-containing adenomas (63.4±8.9 vs. 61.2±12.1 yrs, p=0.55; 0.62±0.41 cm vs. 0.66±0.61 cm, p=0.73). Paneth cell containing adenomas were more likely to occur in the proximal colon (77.4% versus 57.0%, p=0.04). There was a strong association between male gender and Paneth cell-containing adenomas, as 26 of 31 (83.9%) of these adenomas occurred in males compared to 75 of 142 (52.8%) non-Paneth cell-containing adenomas (p=0.002). One SSP (of 104, 0.9%) from 1 patient [of 92, 1.0%)] had Paneth cells [vs. 17.9% (31/173); p=0.000007) adenomas from 24 (of 119, 20.2%; p=0.00018) patients harbored Paneth cells]. Among the SSP group, adjacent mucosa was present in 96 cases and Paneth cell was identified in the adjacent mucosa in 13.5% (13 of 96) cases (vs. 0.9% of SSP harboring Paneth cell, p=0.0004).
Conclusions: Paneth cell differentiation is more common in coloretal adenoma than SSP. Paneth cell-containing adenomas are more common in males and are likely proximally located. Lower frequency of Paneth cell within SSP than that in the adjacent mucosa supports a clonal expansion of and active suppression of Paneth cell differentiation in SSP cells.
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 61, Tuesday Afternoon