Diminutif ve Küçük Kolorektal Poliplerde Kanser Riskinin Değerlendirilmesi

Amaç: Çapı <10 mm olan kolorektal poliplerin tedavisi tartışmalıdır. Çalışmamızın amacı, diminutif (≤5 mm) ve küçük poliplerin (5 – 9 mm) histopatolojik özelliklerini gözden geçirmek ve kolonda <10 mm çapındaki polipler için ileri adenom prevalansını değerlendirmektir. Materyal ve Metod: Endoskopi ünitemizde kolonoskopi yapılan 2312 hastanın tıbbi kayıtları geriye dönük olarak incelendi. Histolojik olarak villöz / tubulovillöz polip, yüksek dereceli displazi veya intramukozal karsinom olarak tanımlanan ilerlemiş adenom varlığını incelendi. Bulgular: Hastaların 448’inde toplam 653 polip tespit edildi ve %90,8 (593/653) oranında polip<10 mm büyüklüğündeydi. Boyutları 10 mm'den küçük 386 konvansiyonel adenom vardı ve bunların 376'si tübüler adenomdu. Adenomatöz olmayan 211 polip vardı ve bunların 162’si hiperplastik polipti. Tüm konvansiyonel adenomların 7'sinda, boyutu ≤5 mm olan adenomların 2 tanesinde ve 6-9 mm boyutundaki adenomların 2 tanesinde yüksek dereceli displazi vardı. Tüm adenomlardan ≤5 mm boyutundakilerin %0.8'i ve 6-9 mm boyutundakilerin %1.65'i advance adenomdu. Boyutları ≤5 mm olan 472 polip ve 6-9 mm boyutlarındaki 121 polipten hiçbirinde kanser saptanmadı.Sonuç: İleri histolojik displastik özelliklerin genel prevalansının diminutif kolon poliplerinde %0,8 ve küçük poliplerde %1.65 bulundu. Diminutif kolon poliplerinde ileri histolojik displastik özellik prevalansı çok düşüktür (%0.8). Mevcut çalışma, Diminutif polipler arasında rezeksiyon ve atma stratejisini destekler nitelikteydi.

Anahtar Kelimeler:

kolorektal polipler, kanser, adenom prevalansı

Evaluation of Cancer Risk in Diminutive and Small Colorectal Polyps

Objective: The treatment of colorectal polyps <10 mm in diameter is controversial. The aim of our study was to review the histopathological features of diminutive (≤ 5 mm) and small polyps (5 – 9 mm) and to evaluate the prevalence of advanced adenoma for polyps <10 mm in diameter in the colon.Materials and methods: Medical records of 2312 patients who underwent colonoscopy in our endoscopy unit were reviewed retrospectively. The presence of advanced adenoma, defined histologically as villous/tubulovillous polyp, high-grade dysplasia, or intramucosal carcinoma, was examined.Results: A total of 653 polyps were detected in 448 of the patients, and 90.8% (593/653) of the polyps were <10 mm in size. There were 386 conventional adenomas less than 10 mm in size, of which 376 were tubular adenomas. There were 211 non-adenomatous polyps, of which 162 were hyperplastic polyps. High-grade dysplasia was present in 7 of all conventional adenomas, 2 of adenomas ≤5 mm in size, and 2 of 6-9 mm adenomas. Of all adenomas, 0.8% of ≤5 mm in size and 1.65% of 6-9 mm in size were advance adenomas. Cancer was not detected in any of the 472 polyps ≤5 mm in size and 121 polyps 6-9 mm in size.Conclusion: The overall prevalence of advanced histological dysplastic features was found to be 0.8% in diminutive colon polyps and 1.65% in small polyps. The prevalence of advanced histological dysplastic features in diminutive colon polyps is very low (0.8%). The present study supported the strategy of resection and expulsion among diminutive polyps.

Keywords:

colorectal polpys, cancer, adenoma prevalence,

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