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Which lesions are at higher risk of developing colorectal carcinomas: superficially elevated serrated lesions or depressed lesions?

##article.authors##

  • Artur Adolfo Parada Faculdade Evangélica Mackenzie do Paraná
  • Filadelfio Euclydes Venco Serviço de Endoscopia Digestiva, Centro de Diagnóstico e Terapêutica Endoscópica de São Paulo, Hospital 9 de Julho, São Paulo, SP, Brasil
  • Miguel Reynaldo Varca-Neto Serviço de Endoscopia Digestiva, Centro de Diagnóstico e Terapêutica Endoscópica de São Paulo, Hospital 9 de Julho, São Paulo, SP, Brasil
  • Matheus Degiovani Serviço de Endoscopia Digestiva, Centro de Diagnóstico e Terapêutica Endoscópica de São Paulo, Hospital 9 de Julho, São Paulo, SP, Brasil.
  • Roberto El Ibrahim Serviço de Endoscopia Digestiva, Centro de Diagnóstico e Terapêutica Endoscópica de São Paulo, Hospital 9 de Julho, São Paulo, SP, Brasil
  • Paula Bechara Polett Serviço de Endoscopia Digestiva, Centro de Diagnóstico e Terapêutica Endoscópica de São Paulo, Hospital 9 de Julho, São Paulo, SP, Brasil
  • Helcio Pedrosa Brito Serviço de Endoscopia Digestiva, Centro de Diagnóstico e Terapêutica Endoscópica de São Paulo, Hospital 9 de Julho, São Paulo, SP, Brasil
  • Stella Karina Marchioro Faculdade Evangélica Mackenzie do Paraná
  • Heloisa de Fátima Sare Faculdade Evangélica Mackenzie do Paraná
  • Osvaldo Malafaia Colégio Brasileiro de Cirurgia Digestiva https://orcid.org/0000-0002-1829-7071

DOI:

https://doi.org/10.1590/SciELOPreprints.4272

Keywords:

Colonoscopy, Mass screening, Colorectal neoplasms, Colon, Polyps

Abstract

Background: There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. Aim: Compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. Methods: Retrospective, cross-sectional and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). Results: In G1, 217 lesions were found in 12653 colonoscopies (1,7%); in G2, 558 lesions in 36174 colonoscopies (1.5%). In G1 there were 63.4% of women and in G2 no gender predominance. Average size was G1 with 16.2 mm and G2 with 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1 there were 214 low-grade intramucosal neoplasia (98,6%) and three high grade intramucosal neoplasia (1,4%). Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, was observed 88 (96.7%) with low-grade intramucosal neoplasia and three (3.3%) high-grade intramucosal neoplasia; in G2, 417 low-grade intramucosal neoplasia (74,7%), 113 high-grade intramucosal neoplasia (20,3%) and 28 (5,0%) submucosal adenocarcinomas (p<0.001). Conclusion: Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas for the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.

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Posted

06/14/2022

How to Cite

Parada , A. A., Venco, F. E., Varca-Neto, M. R., Degiovani, M., El Ibrahim, R., Polett, P. B., Brito, H. P., Marchioro, S. K., Sare , H. de F., & Malafaia, O. (2022). Which lesions are at higher risk of developing colorectal carcinomas: superficially elevated serrated lesions or depressed lesions?. In SciELO Preprints. https://doi.org/10.1590/SciELOPreprints.4272

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Health Sciences
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