Nongranular LNPCPs May Signal Higher Risk for Synchronous Disease

Nongranular large nonpedunculated colorectal polyps (LNPCPs) have a 4-fold greater risk of synchronous disease, according to study findings published online ahead of print in Clinical Gastroenterology and Hepatology.

“LNPCPs may have synchronous LNPCPs in up to 18% of cases. The nature of this relationship has not been investigated,” explained corresponding author Michael J. Bourke, of the Westmead Hospital Department of Gastroenterology and Hepatology in Sydney, Australia, and coauthors in the study background. “We aimed to examine the relationship between individual LNPCP characteristics and synchronous colonic LNPCPs.”

The study included 3381 consecutive patients referred for resection of LNPCPs over the course of a decade.

Synchronous lesions were detected in 232, or 6.9%, of the patients, according to the study. In patients with two or more lesions, 35.8% of dominant LNPCPs were nongranular, compared with 18.7% in the solitary LNPCP cohort.

Nongranular LNPCPs were more likely to signal synchronous disease, the study found. The risk was higher with left colon nongranular LNPCPs (researchers reported a 4.78 odds ratio) compared with right colon NG-LNPCPs (1.99 odds ratio).

“Following endoscopic mucosal resection of non-granular LNPCPs, endoscopists must be mindful of the heightened risk of synchronous lesions and carefully inspect the remaining colon,” the authors advised, “as such lesions are difficult to endoscopically detect.”

—Jolynn Tumolo

Reference:
O'Sullivan T, Tate D, Sidhu M, et al. The surface morphology of large non pedunculated colonic polyps predicts synchronous large lesions. Clin Gastroenterol Hepatol. Published online February 12, 2023. doi:10.1016/j.cgh.2023.01.034