Utility of Sessile Serrated Adenoma as a Marker of Metachronous Colorectal Carcinoma
Mahin Mohammadi, Mads Carstensen, Michael H Kristensen, Hans J Nielsen, Susanne Holck. Hospital South, Naestved, Denmark; Hvidovre Hospital, Hvidovre, Denmark
Background: Identification of cancer precursors facilitates early detection of lesions with high risk of cancer. It is is well-established for conventional adenomas. The clinical significance of the sessile serrated adenoma (SSA) as a marker of metachronous colorectal carcinoma (MCRC) remains elusive, despite mounting evidence implicating the SSA as a significant player in the serrated carcinogenesis. The risk of MCRC (CRC detected more than 12 months after the index intervention) in non-dysplastic SSA is here evaluated.
Design: The base-line material comprised 219 SSAs, identified among 8.834 colorectal polyps originally coded as hyperplastic polyp (HP), as described previously [Mohammadi et al Pathol Res Pract 2011;207:410]. Out-come information within 17 months to 10 years of the index intervention was searched through pathology databases.
Results: During the follow-up period, 3 patients with SSA, all males, aged 45, 56, and 67 years, were diagnosed with MCRC, 1.5, 2, and 10 years, respectively. Further details on index polyp and MCRC are given in table 1.
|Mut. Status||Site||Size mm||Histologic type||Mut. Status||MLH1 protein||Site|
|2.||Braf-mut.||Asc.* Sigm.*||9||Glandular||Braf- and Kras WT||Retained||Rectum|
|3.||Braf-WT||Rectum||11||Mucinous||Kras-mut (12 wasp)||Retained||Left colon|