Endoscopy 2020; 52(S 01): S201
DOI: 10.1055/s-0040-1704627
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 15:30 – 16:00 CRC Screening 1 ePoster Podium 7
© Georg Thieme Verlag KG Stuttgart · New York

CLINICAL AND ENDOSCOPIC DIFFERENCES BETWEEN SESSILE SERRATED ADENOMA/POLYP WITH OR WITHOUT CYTOLOGIC DYSPLASIA AND HYPERPLASTIC POLYP

HW Kim
1   Pusan National University Yangsan Hospital, Internal Medicine, Yangsan-si, Korea, Republic of
,
SB Park
1   Pusan National University Yangsan Hospital, Internal Medicine, Yangsan-si, Korea, Republic of
,
DH Kang
1   Pusan National University Yangsan Hospital, Internal Medicine, Yangsan-si, Korea, Republic of
,
SJ Kim
1   Pusan National University Yangsan Hospital, Internal Medicine, Yangsan-si, Korea, Republic of
,
HS Nam
1   Pusan National University Yangsan Hospital, Internal Medicine, Yangsan-si, Korea, Republic of
,
DG Ryu
1   Pusan National University Yangsan Hospital, Internal Medicine, Yangsan-si, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Sessile serrated adenoma/polyps (SSAPs) are known to develop cancer by the serrated neoplasia pathway. Endoscopic features of SSAPs are well presented in NICE and WASP classification, but SSAPs are often difficult to distinguish hyperplastic polyp (HP) and predict the accompanying dysplasia. We aimed to evaluate the clinical and endoscopic differences between SSAPs with or without cytologic dysplasia and HP.

    Methods Among patients underwent endoscopic resection from January 2015 to June 2018 in PNUYH, patients with HP or SSAP (≥10 mm size) were enrolled. We retrospectively evaluated clinical and endoscopic, pathologic features in these patients.

    Results A total of 175 polyps were assessed in 129 patients (116 HPs and 59 SSAPs). Concordance between endoscopic and pathologic diagnosis of SSAPs was 33.7% (59/175). SSAPs showed a significant difference in size (p< 0.0001), shape (p< 0.0001), diffuse nodular surface

    (p< 0.012), focal nodular elevation (p< 0.023), depression (p< 0.012), ≥2 WASP criteria (p< 0.001), NICE type

    (p< 0.002), Kudo pit pattern (p< 0.0001) compared to HPs. Thirty of 59 SSAPs (50.9%) had cytologic dysplasia at histopathology (21 low-grades, 8 high-grades, 1 carcinoma in situ). SSA/P with dysplasia was significantly different in age (p< 0.0001), size (p< 0.0001), NICE type (p< 0.0001) and Kudo pit pattern (p< 0.0001), but not location, morphology, surface patterns and ≥2 WASP criteria compared to SSAP without cytologic dysplasia. In multivariate analysis, dysplasia was significantly associated with age (OR 1.123, p< 0.005) and size (OR 1.188, p< 0.008), shape

    (OR 0.138, p< 0.05).

    Conclusions Endoscopic diagnosis for SSAPs showed low accuracy. Dysplasia in SSAPs was frequently combined, especially old age and large size. Therefore, comprehensive endoscopic evaluation in case of suspected SSAPs is necessary and SSAPs with findings related with dysplasia should be completely resected.


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