Abstract
Hyperplastic/serrated polyposis syndrome (HPS) is a condition characterized by multiple hyperplastic/serrated colorectal polyps. The risk of colorectal cancer (CRC) is increased in HPS. The clinicopathologic characteristics of HPS in Japanese patients are unknown. The aim of this study is to clarify the clinicopathologic features of HPS in Japanese patients. We retrieved records of patients diagnosed with HPS between April 2008 and March 2011 from the endoscopy database of Hiroshima University Hospital. In addition, we mailed a questionnaire to the hospital's 13 affiliated hospitals in July 2012. Data collected from the database and questionnaires included patient age, sex, number of hyperplastic/serrated polyps and tubular adenomas, size of the largest polyp, polyp location, resection for polyps, coexistence of HPS with CRC, and the diagnostic criterion met. Of the 73,608 patients who underwent colonoscopy, 10 (0.014%) met the criteria for HPS. The mean age of these patients was 58.3 years, and 6 (60%) were men. No subjects had a first-degree relative with HPS. Four (40%) HPS patients had more than 30 hyperplastic/serrated polyps, and average size of the largest polyp was 19 mm. Three (30%) HPS patients had coexistence of HPS with CRC. In these 3 patients, polyps were observed throughout the colorectum. Although HPS was a rare condition in the overall study population, patients with the disease may have high risk of CRC. HPS should be diagnosed correctly and followed up carefully.
Highlights
The incidence of early-onset colorectal cancer (CRC) in the Vietnamese has been reported to be quite higher than that in the Japanese
K-ras mutations were examined in the CRCs of 60 Vietnamese and 45 Japanese patients (Figure 1A)
The frequency of the mutations in the Vietnamese CRCs was significantly higher than that in the Japanese CRCs (8 of 24 [33%] vs 5 of 45 [11%], p =0.048) (Table 4)
Summary
The incidence of early-onset (under 50 years of age) colorectal cancer (CRC) in the Vietnamese has been reported to be quite higher than that in the Japanese. In Vietnam, CRC is the third most common cause of cancer deaths in men and fourth in women [2]. A high incidence of early-onset CRC (that occurring in patients under 50 years of age) has been reported: the ratio of early-onset CRC to all CRCs is approximately 28% [2]. CRC is the third most common cause of cancer death in men and first in women in Japan. The incidence of early-onset CRCs in the Vietnamese may be quite higher than that in the Japanese, implying that the pathways of CRC development, i.e. the pattern of genetic changes in CRCs, in the Vietnamese may differ from those in the Japanese
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