IS SUPERFICIAL COLORECTAL LESIONS WITH LOW AND HIGH GRADES INTRAEPITHELIAL NEOPLASMS MORE PREVALENT IN OLDER ABOVE 65 YEARS?

BACKGROUND: Colorectal cancer has a higher incidence in the rectum and sigmoid. However, with the expansion of the diagnosis of superficial lesions interest in the diagnosis and in the role they play in colorectal carcinogenesis has increased. AIM: To verify the behavior of superficial lesions of the colon and rectum, comparing the pathological and endoscopic findings, below and above 65 years. METHODS: Cross-sectional study with prospective evaluation of standard protocol, where 200 patients with colorectal superficial lesions were evaluated; they were submitted to colonoscopy and mucosectomy of these lesions. They were divided in two age groups, below and above 65 years. RESULTS: One hundred-and-eight were women (54%) and 92 men (46%). Most colon lesions were localized in the right colon (95%) and the remaining (5%) in the rectum. In endoscopy, 77.20% were granular lesions in patients under 65 years and 77.90% above. Colon histology showed low grade intraepithelial neoplasia, being 69.79% in patients under and 73.70% in above 65 years. In rectum, above 65 years the incidence of high-grade intraepithelial neoplasia was higher (66.70%). CONCLUSION: The superficial colorectal lesions have been more endoscopically diagnosed today, and the highest incidence is the granular type, both in the colon and rectum, regardless of age. Regardless the age, histologically colon lesions were more as low grade intraepithelial neoplasia. In rectum, there was distinction for both age groups, being more frequent high grade intraepithelial neoplasia in patients over 65 years.

Is superficial colorectal lesions with low and high grades intraepithelial neoplasms more prevalent in older above 65 years? / Neoplasias intraepiteliais de baixo e alto graus nas lesões superficiais colorretais têm maior prevalência acima de 65 anos de idade?

ABSTRACT Background: Colorectal cancer has a higher incidence in the rectum and sigmoid. However, with the expansion of the diagnosis of superficial lesions interest in the diagnosis and in the role they play in colorectal carcinogenesis has increased. Aim: To verify the behavior of superficial lesions of the colon and rectum, comparing the pathological and endoscopic findings, below and above 65 years. Methods: Cross-sectional study with prospective evaluation of standard protocol, where 200 patients with colorectal superficial lesions were evaluated; they were submitted to colonoscopy and mucosectomy of these lesions. They were divided in two age groups, below and above 65 years. Results: One hundred-and-eight were women (54%) and 92 men (46%). Most colon lesions were localized in the right colon (95%) and the remaining (5%) in the rectum. In endoscopy, 77.20% were granular lesions in patients under 65 years and 77.90% above. Colon histology showed low grade intraepithelial neoplasia, being 69.79% in patients under and 73.70% in above 65 years. In rectum, above 65 years the incidence of high-grade intraepithelial neoplasia was higher (66.70%). Conclusion: The superficial colorectal lesions have been more endoscopically diagnosed today, and the highest incidence is the granular type, both in the colon and rectum, regardless of age. Regardless the age, histologically colon lesions were more as low grade intraepithelial neoplasia. In rectum, there was distinction for both age groups, being more frequent high grade intraepithelial neoplasia in patients over 65 years.

RESUMO Racional: O câncer colorretal tem maior incidência no reto e sigmoide. Porém, com a ampliação do diagnóstico das lesões superficiais do cólon e reto tem-se aumentado o interesse por elas no diagnóstico e no papel que elas representam na carcinogênese colorretal. Objetivo: Verificar o comportamento das lesões superficiais do cólon e reto, comparando os achados anatomopatológicos com os endoscópicos em duas faixas etárias, abaixo e acima de 65 anos. Métodos: Estudo retrospectivo transversal onde foram avaliados 200 pacientes com lesões superficiais colorretais submetidos à colonoscopia e mucosectomia destas lesões. Resultados: Foram 108 mulheres (54%) e 92 homens (46%). A maioria das lesões localizou-se no cólon direito (95%) e as demais (5%) no reto. Quanto ao aspecto endoscópico 77,20% tinham superfície granulosa para pacientes abaixo de 65 anos e 77,90% para os acima. Quanto ao aspecto histológico no cólon a maioria, independentemente da idade, mostrou ser neoplasia intraepitelial de baixo grau, enquanto que no reto, nos mais idosos, a incidência de neoplasia intraepitelial de alto grau foi maior (66,70%). Conclusão: As lesões superficiais colorretais têm sido mais diagnosticadas pela colonoscopia e a forma granular apresenta maior incidência, tanto nos mais jovens como nos mais idosos. Os achados anatomopatológicos no cólon, independente da faixa etária, foram mais de neoplasia intraepitelial de baixo grau. No reto observou-se distinção para as duas faixas etárias, sendo mais frequentes os casos de neoplasia intraepitelial de alto grau para os pacientes acima de 65 anos.