Polyp Characteristics of Nonsyndromic and Potentially Syndromic Juvenile Polyps: A Retrospective Cohort Analysis.
Document Type
Article
Publication Date
12-2019
Identifier
DOI: 10.1097/MPG.0000000000002477; PMCID: PMC6882539
Abstract
BACKGROUND: Juvenile polyps (JPs) are the most common gastrointestinal polyps diagnosed in children. There is paucity of evidence differentiating polyp burden groups and the presence and significance of neoplastic changes.
METHODS: A retrospective chart review of patients, ages birth through 18 years with nonsyndromic JPs was performed from 2003 to 2017. Abstracted data included basic demographics, age, clinical presentation, colonoscopy findings, and pathology report. Slides of polyps with neoplasia were reviewed by a pathologist.
RESULTS: A total of 213 subjects underwent 326 procedures and 435 polypectomies. Subjects with positive family history, positive gene mutations, or numerous (>10) polyps were excluded. Groups were defined by polyp number (1, 2-4, 5-10). Polyp recurrence on repeat colonoscopy was significantly related to polyp burden (1 polyp: 1.5%/2-4 polyps 19.2%/5-10 polyps 82.6%: P < 0.001). Polyp distribution was significantly different amongst different groups with isolated polyps favoring a distal distribution. JPs harboring adenomatous foci were reported in 26 (12%) patients. JPs harboring adenomatous foci were significantly more likely to be proximally distributed but the presence of adenomatous transformation within the polyps did not correlate with polyp number or the likelihood of polyp recurrence on repeat colonoscopy.
CONCLUSIONS: JP recurrence is positively and significantly related to polyp burden. JP harbored adenomatous changes independent of polyp number, underscoring a possible malignant potential in JPs. In the absence of a consistent genotype or pedigree, the presence of adenomatous transformation within JPs cannot be construed as a biomarker for syndromic juvenile polyposis.
Journal Title
Journal of pediatric gastroenterology and nutrition
Volume
69
Issue
6
First Page
668
Last Page
672
MeSH Keywords
Child; Child, Preschool; Colonic Polyps; Colonoscopy; Disease Progression; Female; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Humans; Intestinal Polyposis; Male; Neoplasm Recurrence, Local; Neoplastic Syndromes, Hereditary; Retrospective Studies
Keywords
Child; Child, Preschool; Colonic Polyps; Colonoscopy; Disease Progression; Female; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Humans; Intestinal Polyposis; Male; Neoplasm Recurrence, Local; Neoplastic Syndromes, Hereditary; Retrospective Studies
Recommended Citation
Ibrahimi N, Septer SS, Lee BR, Garola R, Shah R, Attard TM. Polyp Characteristics of Nonsyndromic and Potentially Syndromic Juvenile Polyps: A Retrospective Cohort Analysis. J Pediatr Gastroenterol Nutr. 2019;69(6):668-672. doi:10.1097/MPG.0000000000002477
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