Predictors of Metachronous Risk Polyps After Index Colonoscopy
Carot, Laura (Institut Hospital del Mar d'Investigacions Mèdiques)
Navarro Viu, Gemma (Institut Hospital del Mar d'Investigacions Mèdiques)
Naranjo-Hans, Dolores (Institut Hospital del Mar d'Investigacions Mèdiques)
Iglesias, Mar (Institut Hospital del Mar d'Investigacions Mèdiques)
Dalmases, Alba (Institut Hospital del Mar d'Investigacions Mèdiques)
Fernández Ibarrondo, Lierni (Institut Hospital del Mar d'Investigacions Mèdiques)
Seoane, Agustín (Institut Hospital del Mar d'Investigacions Mèdiques)
Buron, Andrea (Institut Hospital del Mar d'Investigacions Mèdiques)
Bellosillo Paricio, Beatriz (Universitat Autònoma de Barcelona. Departament de Medicina)
Bessa Caserras, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Andreu, Montserrat (Institut Hospital del Mar d'Investigacions Mèdiques)
Alvarez-Urturi, Cristina (Institut Hospital del Mar d'Investigacions Mèdiques)

Date:	2021
Abstract:	We included patients with high-risk lesions (HRLs), defined as advanced adenoma (AA), large serrated polyps (SPs), and multiplicity (≥3 of any adenomas/SPs). Data on age, sex, cardiovascular risk factors, pharmacological treatment, and the histological characteristics in each individual, and mutations in genes involved in the most advanced index polyp, were collected. Parameters independently associated with a metachronous HRL diagnosis were evaluated through univariate and multivariate analyses. The results are reported as odds ratios and 95% confidence intervals along with P values. A total of 537 cases (median age: 60. 7 years; 66% male) were included. Dyslipidemia and smoking correlated with metachronous HRLs. Multivariate logistic regression analysis showed that the presence of multiplicity with ≥3 polyps on the index colonoscopy was significantly associated with metachronous HRL, AA, proximal AA, and ≥3 polyps at 3 years. In addition, independent predictors of metachronous proximal AA were increasing age, female sex, and the loss of expression of the MLH1 protein. Multiplicity was a strong predictor of HRLs at 3 years, although the inclusion of other clinical variables (age, sex, smoking status, and dyslipidemia) improves surveillance recommendations. Without these risk factors, the surveillance could be extended to 5 years; we propose examining the somatic expression of MHL1 in all patients.
Grants:	Instituto de Salud Carlos III PI14-00441 Instituto de Salud Carlos III PT17-0015-0011 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017SGR80
Note:	Altres ajuts: Associación Española Contra el Cáncer (AECC) (PS14152544ANDR)
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Adenoma ; Epidemiology ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Risk Assessment
Published in:	Clinical and Translational Gastroenterology, Vol. 12 (february 2021) , ISSN 2155-384X

DOI: 10.14309/ctg.0000000000000304
PMID: 33605613

10 p, 358.9 KB

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