BACKGROUND Little is known about the natural history of serrated polyps (SPs), partly due to the lack of large-scale epidemiologic data. In this study, we examined the validity of SP identification according to SNOMED (Systematised Nomenclature of Medicine) codes and free text from colorectal histopathology reports. METHODS Through the ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) study, we retrieved data on SPs from all pathology departments in Sweden in 2015-2017 by using SNOMED codes and free-text search in colorectal histopathology reports. Randomly selected individuals with a histopathology report of SPs were validated against patient charts using a structured, retrospective review. RESULTS SPs were confirmed in 101/106 individuals with a histopathology report of SPs, yielding a positive predictive value (PPV) of 95% (95%CI = 89-98%). By year of diagnosis, the PPV was 89% (95%CI = 69-97%), 96% (95%CI = 81-99%) and 97% (95%CI = 89-99%) for individuals diagnosed before 2001 (n = 19), between 2001 and 2010 (n = 26) and after 2010 (n = 61), respectively. According to search method, the PPV for individuals identified by SNOMED codes was 100% (95%CI = 93-100%), and 93% (95%CI = 86-97%) using free-text search. Recorded location (colon vs. rectum) was correct in 94% of all SP histopathology reports (95%CI = 84-98%) identified by SNOMED codes. Individuals with SPs were classified into hyperplastic polyps (n = 34; 32%), traditional serrated adenomas (n = 3; 3%), sessile serrated adenomas/polyps (SSA/Ps) (n = 70; 66%), unspecified SPs (n = 3, 3%), and false positive SPs (n = 5, 5%). For individuals identified by SNOMED codes, SSA/Ps were confirmed in 49/52 individuals, resulting in a PPV of 94% (95%CI: 84-98%). In total, 57% had ≥2 polyps (1: n = 44, 2-3: n = 33 and ≥ 4: n = 27). Some 46% of SPs (n = 71) originated from the proximal colon and 24% were ≥ 10 mm in size (n = 37). Heredity for colorectal cancer, intestinal polyposis syndromes, or both was reported in seven individuals (7%). Common comorbidities included diverticulosis (n = 45, 42%), colorectal cancer (n = 19, 18%), and inflammatory bowel disease (n = 10, 9%). CONCLUSION Colorectal histopathology reports are a reliable data source to identify individuals with SPs.

中文翻译：

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瑞典病理学登记册中锯齿状息肉（SP）的验证。

背景技术关于锯齿状息肉（SP）的自然病程知之甚少，部分原因是缺乏大规模的流行病学数据。在这项研究中，我们根据SNOMED（医学系统命名法）代码和来自结直肠组织病理学报告的自由文本，检查了SP识别的有效性。方法通过ESPRESSO（瑞典的流行病学，其组织病理学报告得到了加强）研究，我们通过使用SNOMED代码和大肠组织病理学报告中的自由文本搜索检索了2015-2017年瑞典所有病理学部门的SP数据。使用结构化的回顾性回顾，根据患者病历表对随机选择的具有SP组织病理学报告的个体进行了验证。结果通过SP的组织病理学报告，在101/106个人中确认了SP，产生95％的阳性预测值（PPV）（95％CI = 89-98％）。根据诊断年份，在之前诊断出的个体中，PPV为89％（95％CI = 69-97％），96％（95％CI = 81-99％）和97％（95％CI = 89-99％） 2001年（n = 19），2001年至2010年（n = 26）和2010年之后（n = 61）。根据搜索方法，使用SNOMED代码识别的个人的PPV使用自由文本搜索为100％（95％CI = 93-100％）和93％（95％CI = 86-97％）。在SNOMED代码确定的所有SP组织病理学报告中，有94％（95％CI = 84-98％）的记录位置（结肠与直肠）正确无误。有SP的个体分为增生性息肉（n = 34; 32％），传统的锯齿状腺瘤（n = 3; 3％），无蒂锯齿状腺瘤/息肉（SSA / Ps）（n = 70; 66％），未指定的SPs （n = 3，3％）和假阳性SP（n = 5，5％）。对于通过SNOMED代码识别的个人，在49/52个人中确认了SSA / P，导致PPV为94％（95％CI：84-98％）。总共有57％的息肉≥2（1：n = 44，2-3：n = 33和≥4：n = 27）。大约46％的SP（n = 71）来自近端结肠，其中24％的大小≥10 mm（n = 37）。据报道有七个人（7％）发生了大肠癌，肠道息肉综合征或两者的遗传。常见合并症包括憩室病（n = 45，42％），大肠癌（n = 19，18％）和炎症性肠病（n = 10，9％）。结论结直肠组织病理学报告是鉴定具有SP的个体的可靠数据源。大约46％的SP（n = 71）来自近端结肠，其中24％的大小≥10 mm（n = 37）。据报道有七个人（7％）发生了大肠癌，肠道息肉综合征或两者的遗传。常见合并症包括憩室病（n = 45，42％），大肠癌（n = 19，18％）和炎症性肠病（n = 10，9％）。结论结直肠组织病理学报告是鉴定具有SP的个体的可靠数据源。大约46％的SP（n = 71）来自近端结肠，其中24％的大小≥10 mm（n = 37）。据报道有七个人（7％）发生了大肠癌，肠道息肉综合征或两者的遗传。常见合并症包括憩室病（n = 45，42％），大肠癌（n = 19，18％）和炎症性肠病（n = 10，9％）。结论结直肠组织病理学报告是鉴定具有SP的个体的可靠数据源。