RISK OF ADVANCED HISTOLOGY IN DIMINUTIVE COLORECTAL POLYPS

Aims The prevalence of advanced histology in diminutive colorectal polyps is a key factor to consider before adopting some polyp management paradigms. We aimed to determine the prevalence and risk factors of advanced histology in diminutive polyps.

Methods We performed analysis of a prospectively maintained database. The colonoscopies included were preformed in patients with moderate risk of developing colorectal cancer. Polyp size, morphology and location in the colon were noted. A pathology examination was performed after polypectomie. Conventional adenomas were interpreted as tubular, tubulovillous or villous. Dysplasia was described as low or high-grade dysplasia. Advanced histology was defined as the detection of high-grade dysplasia or villous elements.

Results A total of 116 diminutive colorectal polyps were collected in 63 patients with a mean age of 56.24±15.12 and a sex ratio of 4.25. Polyps were mostly detected in the sigmoid colon (26.7%) and the rectum (25%). There were 81 conventional adenomas (69.8%) and 32 hyperplastic polyps. Advanced histology was identified in 16.3% of cases with presence of high grade dysplasia and villous elements in 4.3% and 12% respectively. In univariate analysis age of the patient (p=0.01), history of hypertension (p=0.03), history of dyslipidemia (p=0.03), excessive alcohol intake (p=0.01), size of detected polyp (p=0.05) and NICE type2 (p=0.01) were statistically correlated with advanced adenomas. In multivariate analysis, only age and NICE type2 were independent factors associated with advanced histology.

Conclusions we observed a high risk of advanced histology in diminutive colorectal polyps in a group of patients which requires vigilant management to prevent colorectal cancer.

Publication History

Article published online:
14 April 2022