RESUMO RACIONAL: Há ainda lesões que podem ser perdidas nas colonoscopias. Muitas delas poderiam ser serrilhadas superficialmente elevadas ou deprimidas. OBJETIVO: Comparar as características histopatológicas destas lesões e seus riscos para carcinoma invasivo para a submucosa. MÉTODO: Estudo retrospectivo, transversal, observacional comparando 217 lesões serrilhadas superficialmente elevadas com mais de 5 mm e ressecadas por colonoscopias (G1) com 558 lesões deprimidas (G2). RESULTADOS: As 217 lesões do G1 foram encontradas em 12.653 colonoscopias (1,7%) enquanto as 558 do G2 ocorreram dentre 36.174 colonoscopias (1,5%). No G1, 63,4% eram mulheres e no G2 não houve predominância de gênero. O tamanho médio foi no G1, 16,2 mm e no G2, 9,2 mm (p<0,001). G1 predominaram no cólon proximal e G2, no distal e reto (p<0,001). No G1, ocorreram 214 (98,6%) neoplasias mucosas de baixo grau e três de alto grau (1,4%). Excluídos 126 pólipos hiperplásicos e considerados os 91 adenomas sésseis serrilhados, no G1 observou- se 88 (96,7%) neoplasias mucosas de baixo grau e três (3,3%) de alto grau, e no G2, 417 (74,7%) neoplasias mucosas de baixo grau 113 (20,3%) de alto grau e 28 (5,0%) adenocarcinomas invadindo a submucosa (p<0,001). CONCLUSÕES: As lesões deprimidas apresentaram significativamente mais neoplasias mucosas de alto grau e carcinomas invasivos para a submucosa do que as serrilhadas superficialmente elevadas e mais do que os adenomas sésseis serrilhados superficialmente elevados. RACIONAL OBJETIVO MÉTODO retrospectivo transversal 21 G (G1 55 G2. . (G2) RESULTADOS 12653 12 653 12.65 1,7% 17 1 7 (1,7% 36174 36 174 36.17 1,5%. 15 1,5% (1,5%) 634 63 4 63,4 gênero 162 16 2 16, 92 9 9, p<0,001. p0001 p p<0,001 0 001 (p<0,001) 98,6% 986 98 6 (98,6% 1,4%. 14 1,4% (1,4%) observou 8 96,7% 967 96 (96,7% 3,3% 33 3 (3,3% 41 74,7% 747 74 (74,7% 11 20,3% 203 20 (20,3% 5,0% 50 (5,0% CONCLUSÕES elevados (G (G2 1265 65 12.6 1,7 (1,7 3617 36.1 1,5 (1,5% 63, p000 p<0,00 00 (p<0,001 98,6 (98,6 1,4 (1,4% 96,7 (96,7 3,3 (3,3 74,7 (74,7 20,3 (20,3 5,0 (5,0 12. 1, (1, 361 36. (1,5 p00 p<0,0 (p<0,00 98, (98, (1,4 96, (96, 3, (3, 74, (74, 20, (20, 5, (5, (1 p0 p<0, (p<0,0 (98 (96 (3 (74 (20 (5 ( p<0 (p<0, (9 (7 (2 p< (p<0 (p< (p
ABSTRACT BACKGROUND: There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. AIMS: The aim of this study was to compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. METHODS: This is a retrospective, cross-sectional, and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). RESULTS: In G1, 217 lesions were found in 12,653 (1.7%) colonoscopies; in G2, 558 lesions were found in 36,174 (1.5%) colonoscopies. In G1, 63.4% were women and in G2, there was no gender predominance. The average size of G1 was 16.2 mm and G2 was 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1, there were 214 (98.6%) low-grade intramucosal neoplasia and 3 (1.4%) high-grade intramucosal neoplasia. Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, we observed 88 (96.7%) low-grade intramucosal neoplasia and 3 (3.3%) high-grade intramucosal neoplasia; in G2, we observed 417 (74.7%) low-grade intramucosal neoplasia, 113 (20.3%) high-grade intramucosal neoplasia, and 28 (5.0%) submucosal adenocarcinomas (p<0.001). CONCLUSION: Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas in the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas. BACKGROUND colonoscopy ones AIMS carcinoma METHODS retrospective crosssectional, crosssectional cross sectional, sectional cross-sectional 21 G (G1 55 G2. . (G2) RESULTS 12653 12 653 12,65 1.7% 17 1 7 (1.7% 36174 36 174 36,17 1.5% 15 (1.5% 634 63 4 63.4 predominance 162 16 2 16. 92 9 9. p<0.001. p0001 p p<0.001 0 001 (p<0.001) 98.6% 986 98 6 (98.6% lowgrade low grade 1.4% 14 (1.4% highgrade high 8 96.7% 967 96 (96.7% 3.3% 33 (3.3% 41 74.7% 747 74 (74.7% 11 20.3% 203 20 (20.3% 5.0% 50 (5.0% CONCLUSION (G (G2 1265 65 12,6 1.7 (1.7 3617 36,1 1.5 (1.5 63. p000 p<0.00 00 (p<0.001 98.6 (98.6 1.4 (1.4 96.7 (96.7 3.3 (3.3 74.7 (74.7 20.3 (20.3 5.0 (5.0 12, 1. (1. 361 36, p00 p<0.0 (p<0.00 98. (98. 96. (96. 3. (3. 74. (74. 20. (20. 5. (5. (1 p0 p<0. (p<0.0 (98 (96 (3 (74 (20 (5 ( p<0 (p<0. (9 (7 (2 p< (p<0 (p< (p