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Clinicopathological characteristics of colorectal serrated polyposis syndrome (SPS): results of a multicenter study by the SPS Study Group in Japan

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Abstract

Background

Serrated polyposis syndrome (SPS), a type of colorectal polyposis characterized by multiple serrated polyps, is associated with a high risk of colorectal carcinoma (CRC). This study aimed to clarify the clinicopathological characteristics of SPS in Japan.

Methods

We investigated the clinicopathological characteristics of patients with SPS from the “Multicenter Study on Clinicopathological Characteristics of SPS (UMIN 000032138)” by the Colorectal Serrated Polyposis Syndrome (SPS) Study Group. In this study, patients were diagnosed with SPS based on the 2019 World Health Organization (WHO) SPS diagnostic criteria.

Results

Ninety-four patients were diagnosed with SPS in 10 institutions between January 2001 and December 2017. The mean number (± standard deviation [SD]) of resected lesions per patient was 11.3 ± 13.8. The mean age at diagnosis of SPS was 63.3 ± 11.6 years, and 58 patients (61.7%) were male. Eighty-seven (92.6%) and 16 (17.0%) patients satisfied WHO diagnostic criteria I and II, respectively. Nine patients (9.6%) satisfied both criteria I and II. Carcinoma (T1–T4) were observed in 21 patients (22.3%) and 24 lesions. Of the 21 patients with CRC, 19 (90.4%) satisfied diagnostic criterion I, 1 (4.8%) satisfied diagnostic criterion II, and 1 (4.8%) satisfied diagnostic criteria I and II. There was no notable difference in the prevalence of CRC among patients who met diagnostic criterion I, II, and both I and II.

Conclusions

Patients with SPS have a high risk of CRC and should undergo regular surveillance colonoscopy. Raising awareness of this syndrome is crucial.

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References

  1. Ferlay J, Shin H-R, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.

    Article  CAS  Google Scholar 

  2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article  Google Scholar 

  3. Arnold M, Sierra MS, Laversanne M, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683–91.

    Article  Google Scholar 

  4. Bettington M, Walker N, Clouston A, et al. The serrated pathway to colorectal carcinoma: current concepts and challenges. Histopathology. 2013;62:367–86.

    Article  Google Scholar 

  5. Singh R, Zorrón L, Tao C, et al. Sessile serrated adenoma/polyps: where are we at in 2016? World J Gastroenterol. 2016;22:7754–9.

    Article  Google Scholar 

  6. Jass JR, Smith M. Sialic acid and epithelial differentiation in colorectal polyps and cancer—a morphological, mucin and lectin histochemical study. Pathology. 1992;24:233–42.

    Article  CAS  Google Scholar 

  7. Mankaney G, Rouphael C, Burke CA, et al. Serrated polyposis syndrome. Clin Gastroenterol Hepatol. 2020;18:777–9.

    Article  Google Scholar 

  8. IJspeert JEG, Bastiaansen BAJ, Dekker E, et al. Serrated polyposis syndrome: a silent killer when undetected. Endoscopy. 2016;48(Supplement 1 UCTN):E53–4.

  9. Boparai KS, Dekker E, Polak MM, et al. A serrated colorectal cancer pathway predominates over the classic WNT pathway in patients with hyperplastic polyposis syndrome. Am J Pathol. 2011;178:2700–7.

    Article  CAS  Google Scholar 

  10. Mäkinen MJ, George SM, Jernvall P, et al. Colorectal carcinoma associated with serrated adenoma—prevalence, histological features, and prognosis. J Pathol. 2001;193:286–94.

    Article  Google Scholar 

  11. Rosty C, Buchanan DD, Walsh MD, et al. Phenotype and polyp landscape in serrated polyposis syndrome: a series of 100 patients from Genetics Clinics. Am J Surg Pathol. 2012;36:876–82.

    Article  Google Scholar 

  12. Carballal S, Rodríguez-Alcalde D, Moreira L, et al. Colorectal cancer risk factors in patients with serrated polyposis syndrome: a large multicentre study. Gut. 2016;65:1829–37.

    Article  Google Scholar 

  13. Rodríguez-Alcalde D, Carballal S, Moreira L, et al. High incidence of advanced colorectal neoplasia during endoscopic surveillance in serrated polyposis syndrome. Endoscopy. 2019;51:142–51.

    Article  Google Scholar 

  14. IJspeert JEG, Rana SAQ, Atkinson NSS, et al. Clinical risk factors of colorectal cancer in patients with serrated polyposis syndrome: a multicentre cohort analysis. Gut. 2017;66:278–84.

    Article  CAS  Google Scholar 

  15. Hazewinkel Y, Tytgat KMAJ, van Eeden S, et al. Incidence of colonic neoplasia in patients with serrated polyposis syndrome who undergo annual endoscopic surveillance. Gastroenterology. 2014;147:88–95.

    Article  Google Scholar 

  16. Crockett SD, Nagtegaal ID. Terminology, molecular features, epidemiology, and management of serrated colorectal neoplasia. Gastroenterology. 2019;157:949-66.e4.

    Article  Google Scholar 

  17. Rivero-Sanchez L, Lopez-Ceron M, Carballal S, et al. Reassessment colonoscopy to diagnose serrated polyposis syndrome in a colorectal cancer screening population. Endoscopy. 2017;49:44–53.

    PubMed  Google Scholar 

  18. Miwata T, Hiyama T, Oka S, et al. Clinicopathologic features of hyperplastic/serrated polyposis syndrome in Japan. J Gastroenterol Hepatol. 2013;28:1693–8.

    Article  Google Scholar 

  19. IJspeert JEG, Bevan R, Senore C, et al. Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview. Gut. 2017;66:1225–32.

    Article  CAS  Google Scholar 

  20. van Herwaarden YJ, Verstegen MHP, Dura P, et al. Low prevalence of serrated polyposis syndrome in screening populations: a systematic review. Endoscopy. 2015;47:1043–9.

    Article  Google Scholar 

  21. Rosty C, Brosens LAA, Dekker E, et al. Serrated polyposis. In: Arends MJ, Carneiro F, Lax SF, et al., editors. WHO classification of tumours of the digestive system. 5th ed. Lyon: IARC; 2019. p. 532–4.

    Google Scholar 

  22. Dekker E, Bleijenberg A, Balaguer F, et al. Update on the World Health Organization criteria for diagnosis of serrated polyposis syndrome. Gastroenterology. 2020;158:1520–3.

    Article  Google Scholar 

  23. Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal, appendiceal, and anal carcinoma: the 3d English edition [secondary publication]. J Anus Rectum Colon. 2019;3:175–95.

  24. Tanaka S, Saitoh Y, Matsuda T, et al. Evidence-based clinical practice guidelines for management of colorectal polyps. J Gastroenterol. 2015;50:252–60.

    Article  Google Scholar 

  25. Bleijenberg A, Klotz D, Løberg M, et al. Implications of different guidelines for surveillance after serrated polyp resection in United States of America and Europe. Endoscopy. 2019;51:750–8.

    Article  Google Scholar 

  26. van Leerdam ME, Roos VH, van Hooft JE, et al. Endoscopic management of polyposis syndromes: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2019;51:877–95.

    Article  Google Scholar 

  27. Hazewinkel Y, Koornstra J-J, Boparai KS, et al. Yield of screening colonoscopy in first-degree relatives of patients with serrated polyposis syndrome. J Clin Gastroenterol. 2015;49:407–12.

    Article  Google Scholar 

  28. Oquiñena S, Guerra A, Pueyo A, et al. Serrated polyposis: prospective study of first-degree relatives. Eur J Gastroenterol Hepatol. 2013;25:28–32.

    Article  Google Scholar 

  29. Bleijenberg AGC, IJspeert JEG, Hazewinkel Y, et al. The long-term outcomes and natural disease course of serrated polyposis syndrome: over 10 years of prospective follow-up in a specialized center. Gastrointest Endosc. 2020;92:1098-107.e1.

    Article  Google Scholar 

  30. Bleijenberg AGC, Ispeert JEG, van Herwaarden YJ, et al. Personalised surveillance for serrated polyposis syndrome: results from a prospective 5-year international cohort study. Gut. 2020;69:112–21.

    Article  Google Scholar 

  31. Muller C, Yamada A, Ikegami S, et al. Risk of colorectal cancer in serrated polyposis syndrome: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2022;20:622–30.

    Article  CAS  Google Scholar 

  32. Toyoshima N, Sakamoto T, Makazu M, et al. Prevalence of serrated polyposis syndrome and its association with synchronous advanced adenoma and lifestyle. Mol Clin Oncol. 2015;3:69–72.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Ms. Eri Okuda of Medical Research Support, Inc., Osaka Laboratory of Molecular Targeted Cancer Prevention Medicine, Kyoto Prefectural University of Medicine, for her help and cooperation in the collection, data entry, and analysis of the questionnaire. We also gratefully acknowledge the work of the past and present members of our laboratory. This study was funded by the Japanese Society of Gastroenterology. SPS samples were collected from Colorectal Serrated Polyposis Syndrome Study Group, affiliated with the Japanese Society of Gastroenterology.

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Authors and Affiliations

  1. Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan

    Yasutsugu Shimohara & Shiro Oka

  2. Division of Regeneration and Medicine Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3, Kasumi, Minamiku, Hiroshima, 734-8551, Japan

    Yuji Urabe

  3. Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan

    Takashi Hisabe

  4. Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Atsushi Yamada

  5. Department of Gastroenterology, Akita Red Cross Hospital, Akita, Japan

    Hiro-o Matsushita & Bunichiro Kato

  6. Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan

    Hirotsugu Sakamoto & Hironori Yamamoto

  7. Department of Gastroenterology, Fukuyama Medical Center, National Hospital Organization, Hiroshima, Japan

    Joichiro Horii

  8. Division of Gastroenterology, Department of Internal Medicine, Kobe University, Kobe, Japan

    Daisuke Watanabe

  9. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Hirotsugu Eda

  10. Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

    Fumika Nakamura & Tetsuji Takayama

  11. Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Akiko Chino

  12. Division of Gastroenterology, Department of Medicine, Iwate Medical University, Iwate, Japan

    Takayuki Matsumoto

  13. Department of Molecular-Targeting Cancer Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Hideki Ishikawa

  14. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan

    Shinji Tanaka

Authors
  1. Yasutsugu Shimohara
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  2. Yuji Urabe
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  3. Shiro Oka
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  4. Takashi Hisabe
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  5. Atsushi Yamada
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  8. Hirotsugu Sakamoto
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  9. Joichiro Horii
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  15. Tetsuji Takayama
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  16. Takayuki Matsumoto
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  17. Hideki Ishikawa
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  18. Shinji Tanaka
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Contributions

Conceptualization and methodology: YU, HI, TM, and ST; formal analysis and investigation: YS, TH, AY, BK, HS, JH, DW, HE, FN, AC, HY, and TT; writing—original draft preparation: YS and YU; writing—review and editing: YU, SO, and ST; funding acquisition: TM, HI and ST; supervision: SO and ST.

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Correspondence to Yuji Urabe.

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Shimohara, Y., Urabe, Y., Oka, S. et al. Clinicopathological characteristics of colorectal serrated polyposis syndrome (SPS): results of a multicenter study by the SPS Study Group in Japan. J Gastroenterol 57, 300–308 (2022). https://doi.org/10.1007/s00535-022-01859-7

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  • DOI: https://doi.org/10.1007/s00535-022-01859-7

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