Prevalence and Anatomic Distribution of Serrated and Adenomatous Lesions in Patients with Inflammatory Bowel Disease.
Background. Sessile serrated adenomas/polyps (SSA/Ps) and traditional serrated adenomas (TSAs) have not been well characterized in patients with inflammatory bowel disease (IBD). This study assesses the prevalence and anatomic distribution of SSA/Ps, TSAs, and conventional adenomas/dysplasia (Ad/Ds) in IBD patients.Methods. IBD patients with serrated, adenomatous, or hyperplastic lesions between 2005 and 2009 were identified in the regional tertiary-care hospital database. Clinicopathological information was reviewed and the histology of biopsies was reevaluated.Results. Ninety-six Ad/Ds, 25 SSA/Ps, and 4 TSAs were identified in 83 patients. Compared to Ad/Ds, serrated lesions were more prevalent in females (p= 0.046). The prevalence of Ad/Ds was 4.95%, SSA/Ps was 1.39%, and TSAs was 0.31%. No relationship was identified between lesion type and IBD type. Comparing all IBD patients, the distribution of lesion types was significantly different (p= 0.02) with Ad/Ds more common distally, SSA/Ps more common proximally, and TSAs evenly distributed. Among Crohn's disease (CD) patients, a similar distribution difference was noted (p< 0.001). However, ulcerative colitis (UC) patients had a uniform distribution of lesion types (p= 0.320).Conclusions. IBD patients have a lower prevalence of premalignant lesions compared to the general population, and the anatomic distribution of lesions differed between CD and UC patients. These findings may indicate an interaction between lesion and IBD pathogenesis with potential clinical implications.
Department of Pathology and Laboratory Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada.
Lik Hang
LH
Lee
Department of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada.
Marietta
0000-0002-3142-9550
M
Iacucci
Department of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada.
Miriam
M
Fort Gasia
Department of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada.
Subrata
S
Ghosh
Department of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada.
Remo
R
Panaccione
Department of Pathology and Laboratory Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada.
Stefan
S
Urbanski
D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000368:Aged; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000453:epidemiology*; D003106:Colon / Q000473:pathology*; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D003424:Crohn Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology / Q000473:pathology; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology; D007417:Intestinal Polyps / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution