Caracterización fenotípica y seguimiento endoscópico del síndrome de poliposis serrada

Abstract

Colorectal cancer (CRC) is the third more incident malignant tumour worldwide and the first in Spain considering both sexes, and implies high morbidity and mortality. Even though it was assumed during decades that virtually the only precursor lesion ofCRC was colorectal adenoma, for 15–20 years it is known that also serrated polyps (SP) can become malignant –specifically through serrated neoplasia pathway–, originating 25–30% of sporadic CRC. Serrated polyposis syndrome (SPS) –which is the most prevalent colonic polyposis– is a condition characterized by the presence of multiple and/or large SP throughout the colon, and defined by the WHO (2010) as the fulfilment of one or more of these criteria: 1) at least five SP proximal to the sigmoid colon with two or more of these being >10 mm; or 2) any number of SP proximal to the sigmoid colon in an individual who has a first-degree relative with SPS; or 3) more than 20 SP of any size, but distributed throughout the colon. SPS is associated to an increased CRC risk (15.8–36.7%) compared to general population. Nevertheless, it has been shown that once the polyps present at diagnosis are resected (called “colonic clearance”) and under close endoscopic follow-up, CRC risk is only slightly elevated (cumulative incidence of 0–7%at five years)...