锯齿型息肉综合症(SPS)是最常见的结肠息肉综合症之一，与增加的结直肠癌风险有关。最近一项研究对SPS患者的切除阑尾进行了观察，发现23个锯齿状息肉中有6个(26.1%)有组织学异常。我们对大型SPS人群进行了阑尾病变的普遍性和临床相关性评估。分析了在2007年至2020年期间199名SPS患者的前瞻性数据。数据来自内镜和病理报告。对进行(预)大肠镜清除、监测大肠镜检查或包括阑尾的结肠外科手术的患者分别进行了评估，以确定阑尾病变的存在。主要结果是手术组中腺癌和具有高级组织学的锯齿状息肉/腺瘤的普遍性。共包括171名患者，其中110名接受内镜监测，34名接受手术。手术组中的阑尾病变普遍性为14/34(41.2%，95% CI 24.7%-59.3%)，其中没有发现高级别的组织学异常。在(预)清除组中的检出率为1/171(0.6%，95% CI 0.01%-3.2%)，为高级别病变，对非高级别阑尾病变的检出率为3/171(1.8%，95% CI 0.04%-5.0%)，这些都是固有的锯齿状病变。在522个患者年的监测期间，内镜未发现高级别阑尾病变，只有1/110名患者(0.9%，95% CI 0.02%-5.0%)检出了非高级别病变。阑尾病变在SPS患者中很常见。内镜检测率与手术切除阑尾的普遍性存在明显差异，这表明在结肠镜检查中漏诊阑尾病变的情况很常见。然而，高级别的阑尾病变是罕见的，且没有发现阑尾腺癌，这意味着这些病变的临床相关性有限。保留所有权利。

Serrated polyposis syndrome (SPS) is the most prevalent colonic polyposis syndrome and is associated with an increased colorectal cancer risk. A recent study in resected appendices of SPS patients reported that 6/23 (26.1 %) of identified serrated polyps had histological dysplasia. We evaluated the prevalence and clinical relevance of appendiceal lesions in a large SPS cohort.Prospective data from 2007 to 2020 for a cohort of 199 SPS patients were analyzed. Data were retrieved from endoscopy and pathology reports. Patients who underwent (pre)clearance colonoscopies, surveillance colonoscopies, or colorectal surgery including the appendix were separately evaluated for the presence of appendiceal lesions. The primary outcome was the prevalence of adenocarcinomas and serrated polyps/adenomas with advanced histology in the surgery group.171 patients were included, of whom 110 received endoscopic surveillance and 34 underwent surgery. Appendiceal lesion prevalence in the surgery group was 14 /34 (41.2 %, 95 %CI 24.7 %-59.3 %); none were advanced on histology. Detection rates in the (pre)clearance group were 1 /171 (0.6 %, 95 %CI 0.01 %-3.2 %) for advanced and 3 /171 (1.8 %, 95 %CI 0.04 %-5.0 %) for nonadvanced appendiceal lesions, all of which were sessile serrated lesions. During 522 patient-years of surveillance, no advanced appendiceal lesions were detected at endoscopy, and in 1 /110 patients (0.9 %, 95 %CI 0.02 %-5.0 %) was a nonadvanced lesion detected.Appendiceal lesions are common in SPS patients. The discrepancy between the endoscopic detection rate of appendiceal lesions and the reported prevalence in surgically resected appendices suggests a substantial miss-rate of appendiceal lesions during colonoscopy. Advanced appendiceal lesions are however rare and no appendiceal adenocarcinomas occurred, implying limited clinical relevance of these lesions.Thieme. All rights reserved.