Clinical, pathologic, and outcome study of hyperplastic and sessile serrated polyps in inflammatory bowel disease

Jeanne Shen, Joanna A. Gibson, Stephanie Schulte, Hema Khurana, Francis A. Farraye, Jonathan Levine, Robert Burakoff, Sandra Cerda, Taha Qazi, Matthew Hamilton, Amitabh Srivastava, Robert D. Odze

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14 Scopus citations

Abstract

Summary There is evidence that some cancers in patients with inflammatory bowel disease (IBD) develop via the serrated pathway of carcinogenesis. This study examined the clinicopathological features and outcome of 115 IBD patients (65 with ulcerative colitis, 50 with Crohn disease), all with at least 1 serrated polyp at endoscopy or colon resection, including the presence of synchronous and metachronous conventional neoplastic lesions (dysplasia or adenocarcinoma), over an average follow-up period of 56.4 months. Conventional neoplasia was categorized as flat dysplasia (low or high grade), sporadic adenoma, adenoma-like dysplasia-associated lesion or mass, or adenocarcinoma. Overall, 97% of patients had at least 1 hyperplastic polyp (HP), 6% had a sessile serrated adenoma/polyp, and none had a traditional serrated adenoma. Eight patients (7%) had a synchronous conventional neoplastic lesion; only 1 had flat dysplasia (1%) and 2 had adenocarcinoma (2%). Thirteen patients developed a metachronous conventional neoplastic lesion, with 8 developing their conventional neoplasm within an area of previous or concurrent colitis; only 1 patient developed flat dysplasia (1%), and none developed adenocarcinoma. A higher proportion of patients with both an HP and a synchronous conventional neoplastic lesion at index developed a metachronous conventional neoplastic lesion, compared with those with an index HP only (25% versus 7%). These results suggest that IBD patients (both ulcerative colitis and Crohn disease patients) with HP have a very low risk of developing a conventional neoplastic lesion (flat dysplasia or adenocarcinoma) that would warrant surgical resection.

Original languageEnglish (US)
Pages (from-to)1548-1556
Number of pages9
JournalHuman Pathology
Volume46
Issue number10
DOIs
Publication statusPublished - Oct 1 2015

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Keywords

  • Crohn disease
  • Hyperplastic polyp
  • Inflammatory bowel disease
  • Sessile serrated adenoma
  • Sessile serrated polyp
  • Ulcerative colitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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