Increased Prevalence of Colonic Polyps in Patients with Ampullary Adenoma or Carcinoma: A Single-Center Retrospective Study

TL;DR

This study found that patients with ampullary adenoma are more likely to have colonic polyps than controls, suggesting the need for colonoscopies in these patients.

Contribution

The study shows a significant association between ampullary adenoma and increased colonic polyp prevalence, independent of age and dysplasia grade.

Findings

35 patients with ampullary adenoma had a 57% colonic polyp prevalence compared to 51% in controls (p = 0.02).

After adjusting for age, the association between ampullary adenoma and colonic polyps remained significant (p = 0.05).

Polyp prevalence was not linked to the dysplasia grade of the ampullary adenoma.

Abstract

Background/Objectives: Ampullary adenomas are neoplasms of the gastrointestinal tract with malignant potential. They are thought to develop through pathways similar to those involved in colorectal neoplasia. This study aimed to determine the prevalence of colonic polyps in patients with ampullary adenoma. Methods: This retrospective study included a total of 35 patients with ampullary adenoma diagnosed between 2023 and 2024 and 105 sex-matched controls. Colonoscopic findings of the patient and control groups were compared with respect to polyp prevalence. In addition, the effects of dysplasia grade of the ampullary adenoma and patient age on polyp prevalence were evaluated. Results: The study included 35 patients (57% male) and 105 controls (59% male). The mean age was 67.06 ± 13.32 years in patients and 61.28 ± 8.42 years in controls. Colonic polyps were detected in 13 (57%) patients in the low-grade dysplasia (LGD) group, 6 (66%) patients in the high grade dysplasia (HGD) or adenocarcinoma group, and 54 (51%) patients in the control group (p = 0.02). After adjusting for age, colonic polyps remained significantly more frequent in the adenoma group than in controls (p = 0.05). Polyp prevalence was not associated with dysplasia grade on ampullary biopsy, and no significant differences were observed between groups regarding polyp histopathology, location, or size. Conclusions: In conclusion, our study indicates that colorectal polyp prevalence is increased among patients with ampullary adenomas and that this association may be independent of age as well as dysplasia severity. Therefore, colonoscopic evaluation may be recommended for all patients diagnosed with ampullary adenoma.

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