title: Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients.
abstract: OBJECTIVE
  To analyse the clinical features of patients with the serrated lesions in the upper gastrointestinal tract (UPGI) tract.
  
  
  METHODS
  Patients who underwent routine esophagogastroduodenoscopy (EGD) at the Digestive Endoscopy Centre of General Hospital, Tianjin Medical University between January 2011 and December 2015 were consecutively recruited. Patients with UPGI serrated lesions were consecutively identified. The patients' demographics and histopathology were recorded. The colorectal findings for patients who underwent colonoscopy simultaneously or within six months were also extracted from the colonoscopy database. In addition, we analysed differences in colorectal neoplasia detection between the study patients and randomly selected patients matched for age and gender who did not exhibit serrated lesions and who also underwent colonoscopy in the same period.
  
  
  RESULTS
  A total of 21 patients out of 98746 patients (0.02%) who underwent EGD were confirmed to have serrated lesions with predominantly crenated, sawtooth-like configurations. The mean age of the 21 patients was (55.3 ± 17.2) years, and 11 patients were male (52.4%). In terms of the locations of the serrated lesions, 17 were found in the stomach (including 3 in the cardia, 9 in the corpus and 5 in the antrum), 3 were found in the duodenum, and 1 was found in the esophagus. Serrated lesions were found in different mucosal lesions, with 14 lesions were detected in polyps (8 hyperplastic polyps and 6 serrated adenomas with low grade dysplasia), 3 detected in Ménétrier gastropathy, 3 detected in an area of inflammation or ulcer, and 1 detected in the intramucosal carcinoma of the duodenum. In addition, colonoscopy data were available for 18 patients, and a significantly higher colorectal adenoma detection rate was observed in the UPGI serrated lesions group than in the randomly selected age- and gender-matched group without serrated lesions who also underwent colonoscopy in the same period (38.9%vs11.1%, OR = 5.091, 95%CI: 1.534-16.890,P= 0.010). The detection rate of advanced adenoma was also higher in the UPGI serrated lesions group (22.2%vs4.2%, OR = 6.571, 95%CI: 1.322-32.660,P= 0.028).
  
  
  CONCLUSIONS
  Serrated lesions in the UPGI were detected in various mucosal lesions with different pathological morphologies. Moreover colonoscopy is recommended for the detection of concurrent colorectal adenoma for these patients.
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: Cao
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Wen-Xiao
authors.initials: WX
authors.lastname: Dong
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Meng-Que
authors.initials: MQ
authors.lastname: Xu
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhang
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Si-Nan
authors.initials: SN
authors.lastname: Wang
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Piao
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Xiao-Cang
authors.initials: XC
authors.lastname: Cao
authors.affiliation: Hai-Long Cao, Wen-Xiao Dong, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang, Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin Institute of Digestive Disease, Tianjin 300052, China.
authors.forename: Bang-Mao
authors.initials: BM
authors.lastname: Wang
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D004379:Duodenal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology
keywords: Clinical features; Colorectal adenoma; Colorectal cancer; Serrated lesions; Upper gastrointestinal tract