PREDICTIVE FACTORS OF DYSPLASIA ON COLONIC POLYPS

Abstract

Introduction: The clinical importance of colonic polyps resides in the risk of adenoma progression to colon cancer (the “adenoma‐carcinoma” sequence).Objectives: To evaluate the presence of dysplasia on colon polyps and identify factors which are predictive of high‐grade changes.Material and methods: Histopathologic studies were carried out on 357 polyps, excised from 334 patients, out of 1423 colonoscopies performed in 2006.Results: Most (77.5%) polyps were distal to the splenic flexure, and the majority was found in the sigmoid colon; 71.8% were tubular adenomas. Low‐grade changes were found in 22.5% of the adenomas, while 77.5% showed high‐grade dysplasia. Only 6.4% of polyps were larger than 2 cm, while 60.1% measured less than 1 cm; 11.2% of the latter had high‐grade dysplasia.Conclusions:1 ‐ All polyps should be excised, regardless of their size, since high‐grade dysplasia can be found in more than 10% of small polyps;2 – High‐grade dysplasia was more likely in polyps larger than 1 cm, and especially those larger than 2 cm;3‐ High‐grade dysplasia was also more frequent in distal, villous and stalked polyps.