The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease

Whitney E. Jackson, Jean Paul Achkar, Carole Macaron, Lili Lee, Xiuli Liu, Rish Pai, Rocio Lopez, Carol A. Burke, Daniela S. Allende

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The significance of serrated lesions in inflammatory bowel disease (IBD) remains unclear. We aim to characterize synchronous and metachronous lesions in IBD patients with an index serrated polyp and compare them to sporadic subjects with SSP. Methods: Serrated lesions in patients with IBD were identified from a pathology database and, after review, were reclassified as hyperplastic (HP), sessile serrated (SSPs), or serrated polyps unclassifiable (SPU). Results: One hundred thirty-four IBD patients were found to have 147 serrated polyps at index colonoscopy. SSPs were more likely to be located in the right colon: SSP (76.0%), SPU (41.7%) and HP (27.8%); P = 0.002. Synchronous multifocal visible dysplasia occurred more frequently in the SSP or SPU groups (44.5% and 66%) compared to the HP group (12%); P = 0.031. Among 13 IBD patients with index SSP followed over a median of 6 years, 61.5% developed metachronous visible dysplasia or additional SSPs. Larger index SSP size was associated with higher risk of developing subsequent visible dysplasia with a 10% increase for every 1 mm increase in size (HR = 1.1; P = 0.028), but was not associated with developing subsequent SSP (P = 0.50). The risk of subsequent SSP or visible dysplasia was no different between the IBD and non-IBD groups, but there was a trend suggesting SSP may be a marker of increased early risk of metachronous visible dysplasia in IBD patients. Conclusions: IBD patients with an index SSP and SPU have a heightened risk of synchronous multifocal visible dysplasia. Additionally, IBD patients with SSP may be at risk of early metachronous visible dysplasia.

Original languageEnglish (US)
Pages (from-to)2213-2220
Number of pages8
JournalInflammatory Bowel Diseases
Volume22
Issue number9
DOIs
StatePublished - Aug 10 2016

Fingerprint

Polyps
Inflammatory Bowel Diseases
Colonoscopy
Colon
Databases
Pathology

Keywords

  • dysplasia
  • IBD
  • inflammatory bowel disease
  • sessile serrated polyp
  • SSP

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

Cite this

Jackson, W. E., Achkar, J. P., Macaron, C., Lee, L., Liu, X., Pai, R., ... Allende, D. S. (2016). The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease. Inflammatory Bowel Diseases, 22(9), 2213-2220. https://doi.org/10.1097/MIB.0000000000000895

The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease. / Jackson, Whitney E.; Achkar, Jean Paul; Macaron, Carole; Lee, Lili; Liu, Xiuli; Pai, Rish; Lopez, Rocio; Burke, Carol A.; Allende, Daniela S.

In: Inflammatory Bowel Diseases, Vol. 22, No. 9, 10.08.2016, p. 2213-2220.

Research output: Contribution to journalArticle

Jackson, WE, Achkar, JP, Macaron, C, Lee, L, Liu, X, Pai, R, Lopez, R, Burke, CA & Allende, DS 2016, 'The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease', Inflammatory Bowel Diseases, vol. 22, no. 9, pp. 2213-2220. https://doi.org/10.1097/MIB.0000000000000895
Jackson, Whitney E. ; Achkar, Jean Paul ; Macaron, Carole ; Lee, Lili ; Liu, Xiuli ; Pai, Rish ; Lopez, Rocio ; Burke, Carol A. ; Allende, Daniela S. / The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease. In: Inflammatory Bowel Diseases. 2016 ; Vol. 22, No. 9. pp. 2213-2220.
@article{43d8a0ac08094139938ed679a6af2abd,
title = "The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease",
abstract = "Background: The significance of serrated lesions in inflammatory bowel disease (IBD) remains unclear. We aim to characterize synchronous and metachronous lesions in IBD patients with an index serrated polyp and compare them to sporadic subjects with SSP. Methods: Serrated lesions in patients with IBD were identified from a pathology database and, after review, were reclassified as hyperplastic (HP), sessile serrated (SSPs), or serrated polyps unclassifiable (SPU). Results: One hundred thirty-four IBD patients were found to have 147 serrated polyps at index colonoscopy. SSPs were more likely to be located in the right colon: SSP (76.0{\%}), SPU (41.7{\%}) and HP (27.8{\%}); P = 0.002. Synchronous multifocal visible dysplasia occurred more frequently in the SSP or SPU groups (44.5{\%} and 66{\%}) compared to the HP group (12{\%}); P = 0.031. Among 13 IBD patients with index SSP followed over a median of 6 years, 61.5{\%} developed metachronous visible dysplasia or additional SSPs. Larger index SSP size was associated with higher risk of developing subsequent visible dysplasia with a 10{\%} increase for every 1 mm increase in size (HR = 1.1; P = 0.028), but was not associated with developing subsequent SSP (P = 0.50). The risk of subsequent SSP or visible dysplasia was no different between the IBD and non-IBD groups, but there was a trend suggesting SSP may be a marker of increased early risk of metachronous visible dysplasia in IBD patients. Conclusions: IBD patients with an index SSP and SPU have a heightened risk of synchronous multifocal visible dysplasia. Additionally, IBD patients with SSP may be at risk of early metachronous visible dysplasia.",
keywords = "dysplasia, IBD, inflammatory bowel disease, sessile serrated polyp, SSP",
author = "Jackson, {Whitney E.} and Achkar, {Jean Paul} and Carole Macaron and Lili Lee and Xiuli Liu and Rish Pai and Rocio Lopez and Burke, {Carol A.} and Allende, {Daniela S.}",
year = "2016",
month = "8",
day = "10",
doi = "10.1097/MIB.0000000000000895",
language = "English (US)",
volume = "22",
pages = "2213--2220",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - The Significance of Sessile Serrated Polyps in Inflammatory Bowel Disease

AU - Jackson, Whitney E.

AU - Achkar, Jean Paul

AU - Macaron, Carole

AU - Lee, Lili

AU - Liu, Xiuli

AU - Pai, Rish

AU - Lopez, Rocio

AU - Burke, Carol A.

AU - Allende, Daniela S.

PY - 2016/8/10

Y1 - 2016/8/10

N2 - Background: The significance of serrated lesions in inflammatory bowel disease (IBD) remains unclear. We aim to characterize synchronous and metachronous lesions in IBD patients with an index serrated polyp and compare them to sporadic subjects with SSP. Methods: Serrated lesions in patients with IBD were identified from a pathology database and, after review, were reclassified as hyperplastic (HP), sessile serrated (SSPs), or serrated polyps unclassifiable (SPU). Results: One hundred thirty-four IBD patients were found to have 147 serrated polyps at index colonoscopy. SSPs were more likely to be located in the right colon: SSP (76.0%), SPU (41.7%) and HP (27.8%); P = 0.002. Synchronous multifocal visible dysplasia occurred more frequently in the SSP or SPU groups (44.5% and 66%) compared to the HP group (12%); P = 0.031. Among 13 IBD patients with index SSP followed over a median of 6 years, 61.5% developed metachronous visible dysplasia or additional SSPs. Larger index SSP size was associated with higher risk of developing subsequent visible dysplasia with a 10% increase for every 1 mm increase in size (HR = 1.1; P = 0.028), but was not associated with developing subsequent SSP (P = 0.50). The risk of subsequent SSP or visible dysplasia was no different between the IBD and non-IBD groups, but there was a trend suggesting SSP may be a marker of increased early risk of metachronous visible dysplasia in IBD patients. Conclusions: IBD patients with an index SSP and SPU have a heightened risk of synchronous multifocal visible dysplasia. Additionally, IBD patients with SSP may be at risk of early metachronous visible dysplasia.

AB - Background: The significance of serrated lesions in inflammatory bowel disease (IBD) remains unclear. We aim to characterize synchronous and metachronous lesions in IBD patients with an index serrated polyp and compare them to sporadic subjects with SSP. Methods: Serrated lesions in patients with IBD were identified from a pathology database and, after review, were reclassified as hyperplastic (HP), sessile serrated (SSPs), or serrated polyps unclassifiable (SPU). Results: One hundred thirty-four IBD patients were found to have 147 serrated polyps at index colonoscopy. SSPs were more likely to be located in the right colon: SSP (76.0%), SPU (41.7%) and HP (27.8%); P = 0.002. Synchronous multifocal visible dysplasia occurred more frequently in the SSP or SPU groups (44.5% and 66%) compared to the HP group (12%); P = 0.031. Among 13 IBD patients with index SSP followed over a median of 6 years, 61.5% developed metachronous visible dysplasia or additional SSPs. Larger index SSP size was associated with higher risk of developing subsequent visible dysplasia with a 10% increase for every 1 mm increase in size (HR = 1.1; P = 0.028), but was not associated with developing subsequent SSP (P = 0.50). The risk of subsequent SSP or visible dysplasia was no different between the IBD and non-IBD groups, but there was a trend suggesting SSP may be a marker of increased early risk of metachronous visible dysplasia in IBD patients. Conclusions: IBD patients with an index SSP and SPU have a heightened risk of synchronous multifocal visible dysplasia. Additionally, IBD patients with SSP may be at risk of early metachronous visible dysplasia.

KW - dysplasia

KW - IBD

KW - inflammatory bowel disease

KW - sessile serrated polyp

KW - SSP

UR - http://www.scopus.com/inward/record.url?scp=84983651715&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84983651715&partnerID=8YFLogxK

U2 - 10.1097/MIB.0000000000000895

DO - 10.1097/MIB.0000000000000895

M3 - Article

C2 - 27508509

AN - SCOPUS:84983651715

VL - 22

SP - 2213

EP - 2220

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 9

ER -