Affiliation:
1. Department of Gastroenterology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province China
Abstract
ObjectiveWe aimed to compare the clinical and endoscopic characteristics of sessile serrated lesions (SSLs) with dysplasia/carcinoma (SSLD/Cs) and SSLs without dysplasia in this systematic review and meta‐analysis.MethodsMEDLINE, EMBASE, and Cochrane Library databases and Clinicaltrials.gov were searched for relevant studies published up to August 28, 2023. The primary outcome was lesion size in SSLD/Cs and SSLs without dysplasia. The secondary outcomes included risk of dysplasia/carcinoma, morphology (classified based on the Paris classification), and lesion features such as mucus cap and nodules/protrusions in the two groups.ResultsThirteen studies with 14 381 patients were included. The proportion of SSLD/Cs ≥10 mm was significantly higher than that of SSLs without dysplasia (odds ratio [OR] 3.82, 95% confidence interval [CI] 1.21–12.02, p = 0.02). There was no significant difference in the risk of dysplasia/carcinoma between the proximal (OR 0.80, 95% CI 0.57–1.14) and distal colon (OR 1.25, 95% CI 0.88–1.77, p = 0.21). The 0‐Ip (OR 2.47, 95% CI 1.50–4.09) and 0‐IIa + Is (OR 10.38, 95% CI 3.08–34.98) morphologies were more prevalent among SSLD/Cs, whereas the 0‐IIa morphology (OR 0.38, 95% CI 0.22–0.65) was more prevalent among SSLs without dysplasia (all p < 0.001). Furthermore, mucus cap (OR 0.61, 95% CI 0.42–0.89, p = 0.01) was more common among SSLs without dysplasia, whereas nodules/protrusions (OR 7.80, 95% CI 3.07–19.85, p < 0.001) were more common in SSLD/Cs.ConclusionSSLs >10 mm, 0‐Ip or 0‐IIa + Is morphologies, and those with nodules/protrusions are significantly associated with dysplasia/carcinoma.