PHÂN LOẠI MÔ BỆNH HỌC CÁC TỔN THƯƠNG/POLYP RĂNG CƯA THEO CẬP NHẬT WHO 2019

Abstract

Background: 2019 WHO classification, there have been important changes in classification, terminology, categorization, and diagnostic criteria for serrated lesions/polyps of colorectal. Objectives: (1) Describe some clinical characteristics (age, sex, location, size), (2) Histopathological classification according to the WHO 2019 update of serrated lesions/polyps of colorectal. Methods: 136 cases/130 patients are screened by diagnostic, keywords, and images from 1915 cases that have been diagnosed with serrated lesions/polyps of colorectal at the Pathology Department, Ho Chi Minh City University of Medicine and Pharmacy from 01/2019 to 05/2021. Results: The age of infection of serrated lesions/polyps in the colorectal is recorded from 30-92 years old, of which the peak of 61-70. The proportion of men with the disease is nearly twice as high as women. Hyperplastic polyps (HP), Sessile serrated lesions (SSL), and Traditional serrated adenoma (TSA) are usually located in the distal colon while the sessile serrated lesions with dysplasia (SSLD) there in a close position. HP and SSL are usually smaller than 5mm, SSLD may be small or 5mm large, but the majority is less than 10mm, and TSA is usually larger than 10mm. In 110 cases diagnosed with serrated polyps/lesions, classified according to WHO 2019 update, the following results were obtained: 25 HP, 07 SSL, 08 SSLD, 24 TSA, 01 unclassified serrated adenoma (USA), and 45 cases were not classified as serrated polyps/lesions. In 64 cases of HP suspected of belonging to other serrated lesions/polyps, classification according to the WHO 2019 update obtained results: 51 HP, 08 SSL, 03 SSLD, 02 TSA. 29 cases of tubulovillous adenomas (TVA) suspected of belonging to other serrated lesions/polyps, reclassified according to WHO 2019 update, obtained results: 27 TVA, 02 TSA. Conclusions: The age of the disease was recorded from 30 to 92 years old, the peak age of the affected groups was similar from 61 to 70 years old, and the rate of men infected was nearly twice that of women. HP, SSL, and TSA are more commonly located in the distal colon than in the proximal colon, while SSLD is roughly equivalent. HP and SSL are usually smaller than 5mm, SSLD can be smaller or larger than 5mm but most are smaller than 10mm, and TSA is usually bigger than 10mm. The change in SSL and TSA diagnosis criteria led to the need to reclassify these two groups of lesions. SSL and SSLD may be omitted from the HP group, and TSA may be omitted from TVA.