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Serrated and non-serrated polyps of the colorectum: their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma

Serrated and non-serrated polyps of the colorectum: their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma
Serrated and non-serrated polyps of the colorectum: their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma
Aims: To determine the prevalence of colorectal polyps of different types in an unselected population, and to correlate the morphological diagnoses with BRAF mutation analysis.

Methods: Cases of colorectal polyps diagnosed at endoscopy were retrieved from the files of Southern.IML Pathology. All slides were reviewed and the lesions classified histologically. A diagnosis of sessile serrated adenoma was made even if the characteristic features were present only focally. If there was more than one polyp of a particular type in any patient, one lesion was chosen at random so that the results represent the number of patients with each type of polyp rather than the total number of polyps. A proportion of the polyps was subjected to BRAF mutation analysis.

Results: A total of 1479 patients were identified. Non-serrated ("conventional") adenomas were found in 964 patients (65%), hyperplastic polyps in 437 (30%), sessile serrated adenomas in 57 (3.9%), traditional serrated adenomas in 11 (0.7%) and mixed hyperplastic adenomatous polyps in 10 (0.7%). BRAF V600E mutation analysis was performed in 148 selected cases; mutations were found in 44/49 (90%) of lesions diagnosed as sessile serrated adenoma, in 10/34 (29%) of hyperplastic polyps of microvesicular type, in 4/11 (36%) of traditional serrated adenomas, in 10/10 (100%) of mixed hyperplastic adenomatous polyps, and in 2/42 (5%) of "conventional" adenomas.

Conclusions: Sessile serrated adenomas are encountered commonly in routine endoscopy practice. The histological diagnosis correlates strongly with the presence of BRAF mutation.
0021-9746
516-518
Carr, N.J.
810e44dc-90d5-496c-85b6-6b2fa1c07dd7
Mahajan, H.
99722e0b-ffe4-4dab-b8bf-503799b68bb1
Tan, K.L.
30ac5b87-fe76-4784-849a-ffaccd589d7c
Hawkins, N.J.
68e15689-aacd-4dc9-a6fc-a58bfbc6ba60
Ward, R.L.
03a13477-50a6-4ed8-a036-54e0e5e1a010
Carr, N.J.
810e44dc-90d5-496c-85b6-6b2fa1c07dd7
Mahajan, H.
99722e0b-ffe4-4dab-b8bf-503799b68bb1
Tan, K.L.
30ac5b87-fe76-4784-849a-ffaccd589d7c
Hawkins, N.J.
68e15689-aacd-4dc9-a6fc-a58bfbc6ba60
Ward, R.L.
03a13477-50a6-4ed8-a036-54e0e5e1a010

Carr, N.J., Mahajan, H., Tan, K.L., Hawkins, N.J. and Ward, R.L. (2009) Serrated and non-serrated polyps of the colorectum: their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma. Journal of Clinical Pathology, 62, 516-518. (doi:10.1136/jcp.2008.061960). (PMID:19126563)

Record type: Article

Abstract

Aims: To determine the prevalence of colorectal polyps of different types in an unselected population, and to correlate the morphological diagnoses with BRAF mutation analysis.

Methods: Cases of colorectal polyps diagnosed at endoscopy were retrieved from the files of Southern.IML Pathology. All slides were reviewed and the lesions classified histologically. A diagnosis of sessile serrated adenoma was made even if the characteristic features were present only focally. If there was more than one polyp of a particular type in any patient, one lesion was chosen at random so that the results represent the number of patients with each type of polyp rather than the total number of polyps. A proportion of the polyps was subjected to BRAF mutation analysis.

Results: A total of 1479 patients were identified. Non-serrated ("conventional") adenomas were found in 964 patients (65%), hyperplastic polyps in 437 (30%), sessile serrated adenomas in 57 (3.9%), traditional serrated adenomas in 11 (0.7%) and mixed hyperplastic adenomatous polyps in 10 (0.7%). BRAF V600E mutation analysis was performed in 148 selected cases; mutations were found in 44/49 (90%) of lesions diagnosed as sessile serrated adenoma, in 10/34 (29%) of hyperplastic polyps of microvesicular type, in 4/11 (36%) of traditional serrated adenomas, in 10/10 (100%) of mixed hyperplastic adenomatous polyps, and in 2/42 (5%) of "conventional" adenomas.

Conclusions: Sessile serrated adenomas are encountered commonly in routine endoscopy practice. The histological diagnosis correlates strongly with the presence of BRAF mutation.

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Published date: 6 January 2009

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Local EPrints ID: 67534
URI: https://eprints.soton.ac.uk/id/eprint/67534
ISSN: 0021-9746
PURE UUID: a99829bb-18f4-4a51-9e55-f8821de741ad

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Date deposited: 24 Aug 2009
Last modified: 19 Jul 2017 00:19

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