RECOGNITION OF COLORECTAL SESSILE SERRATED ADENOMA/POLYP (SSA/P) COULD BE IMPROVED IN BOTH ENDOSCOPISTS AND PATHOLOGISTS (P.S.: THIS ARTICLE WAS SELECTED AS POSTER DEMONSTRATION IN DDW 2017)

Aims:

The diagnosis of “colorectal sessile serrated adenoma/polyp (SSA/P)” is released by WHO classification system of tumor of the digestive system in 2010. From literature, the endoscopic detection and pathologic diagnosis varies among centers. Besides, colorectal SSA/P is easily overlooked under endoscopy and mis-diagnosed as hyperplastic polyp under microscopy. Thus, we intended to analyze the changes of endoscopic detection and pathologic diagnosis after 2010, along with related factors.

Methods:

Reviewing pathological database of our hospital from January, 2011 to December, 2015. All colorectal SSA/Ps detected under the endoscopy and diagnosed by pathologists were analyzed annually; all non-cancerous colorectal polyps were also analyzed annually. Three pathologists and seven endoscopists were enrolled into the study.

Results:

Overall 9882 non-cancerous colorectal polyps were within 5 years. Totally 295 SSA/Ps were diagnosed (295/9882, 2.99%), with a dysplastic rate = 3.4% (10/295). Mean diagnostic age = 54.1 ± 12.4yrs, with a male predominance and right side predominance (M: 62.4%; Right: 63.8%). Yearly number of colorectal SSA/P increased; yearly diagnostic rate of colorectal SSA/P (pathologically detected SSA/Ps/pathologically detected total non-cancerous polyps) also increased (p < 0.05). The diagnostic ratio of three pathologists went to an even and steady state gradually. All three pathologists showed a significant increase in SSA/P diagnostic rate (p < 0.05). The yearly diagnostic number of seven endosopists also increased. However, five of seven endoscopists had SSA/P detection rate increased significantly (p < 0.05). The two endoscopists failing to show significant increase in SSA/P detection rate were discovered to have lower adenoma detection rate (ADR). Both adjusted odds ratios (ORs) for SSA/P detection rate in endoscopists and diagnostic rate in pathologists showed significant increase (p < 0.05).

Conclusions:

Our study showed that the recognition of colorectal sessile serrated adenoma/polyp (SSA/P) could be improved in endoscopists and pathologists. However, this incremental trend is not significant in endoscopists having lower ADR.