Colorectal polyps more common in sporadic ampullary adenoma

Patients with sporadic ampullary tumours more commonly have colorectal polyps or neoplasia than healthy controls, a recent study has found.

Researchers conducted a retrospective analysis of 135 patients undergoing endoscopic ampullectomy. Ninety-five (mean age 57.7 years, 58.9 percent men) were found to have sporadic ampullary adenoma and underwent total colonoscopy. A parallel group of 380 asymptomatic controls (mean age 57.7 years, 58.9 percent men) was included.

Colorectal neoplasia of any histology—including hyperplastic polyps, adenomas, and carcinomas—were reported in 60 percent of sporadic ampullary adenoma patients, as opposed to only 34.7 percent of controls.

Conditional logistic regression analysis found that those with ampullary tumours were 1.7 times (95 percent confidence interval [CI], 1.3–2.4; p=0.001) more likely to have any kind of colorectal neoplasia than controls.

The same was true for advanced colorectal adenoma, which was more than four times as likely to occur in cases vs controls (odds ratio [OR], 4.2, 95 percent CI, 2.2–8.2; p<0.001). Colorectal carcinoma did not differ in frequency between groups.

Polyps sized 6–10 mm (28.7 percent vs 14.8 percent) and >11 mm (10.8 percent vs 5.8 percent) were also significantly more common in controls than in cases (p<0.001).

“The present study recommends routine colonoscopy in patients with sporadic ampullary tumours,”
 the researchers said. “Future larger-scale multicentre research and exploration of the underlying mechanisms are warranted to provide a better understanding of ampullary epithelial tumours.”