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Prospective evaluation of the proportion of sessile serrated adenoma/polyps in endoscopically diagnosed colorectal polyps with hyperplastic features.

Sano W, Sano Y, Iwatate M, Hasuike N, Hattori S, Kosaka H, Ikumoto T, Kotaka M, Fujimori T - Endosc Int Open (2015)

Bottom Line: All of 21 SSA/Ps identified in 17 patients were included in E-HPs, and the overall proportion of SSA/Ps in E-HPs was 2.7 %.However, this proportion increased with the size of E-HPs (≤ 5 mm: 0.7 %; 6 - 9 mm: 29.0 %; ≥ 10 mm: 70 %) and was higher in the proximal colon than in the distal colorectum (10.9 % vs. 0.9 %).The overall proportion of SSA/Ps in E-HPs was 2.7 %, although this proportion was higher in the proximal colon and increased with the size of E-HPs.

View Article: PubMed Central - PubMed

Affiliation: Gastrointestinal Center, Sano Hospital, Hyogo, Japan.

ABSTRACT

Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) are considered precursors of colorectal cancers with microsatellite instability. However, it is still difficult to differentiate SSA/Ps from hyperplastic polyps endoscopically; therefore, the prevalence of SSA/Ps remains uncertain in clinical practice. This study aimed to clarify the proportion of SSA/Ps in endoscopically diagnosed colorectal polyps with hyperplastic features (E-HPs).

Patients and methods: Patients aged ≥ 40 years undergoing colonoscopy for standard clinical indications at our center were prospectively enrolled between June 2013 and May 2014. During colonoscopy, 0.05 % indigo carmine dye was sprayed throughout the colorectum to highlight lesions. All detected lesions were diagnosed by high definition magnifying narrow-band imaging and were resected endoscopically or surgically, apart from rectosigmoid E-HPs ≤ 5 mm. The number of rectosigmoid E-HPs ≤ 5 mm was recorded, and some were resected for use as tissue samples.

Results: A total of 343 patients (male: 42.9 %; mean age: 61.5 years) were included. Among 3838 E-HPs (distal: 96.4 %) detected in 294 patients, 792 were resected and analyzed. All of 21 SSA/Ps identified in 17 patients were included in E-HPs, and the overall proportion of SSA/Ps in E-HPs was 2.7 %. However, this proportion increased with the size of E-HPs (≤ 5 mm: 0.7 %; 6 - 9 mm: 29.0 %; ≥ 10 mm: 70 %) and was higher in the proximal colon than in the distal colorectum (10.9 % vs. 0.9 %). In addition, no SSA/P was found in the rectum, and no SSA/P had cytological dysplasia.

Conclusions: The overall proportion of SSA/Ps in E-HPs was 2.7 %, although this proportion was higher in the proximal colon and increased with the size of E-HPs. SSA/Ps were common in routine colonoscopy, with a prevalence of at least 5.0 %.

Study registration: UMIN000010832.

No MeSH data available.


Related in: MedlinePlus

 An example of a sessile serrated adenoma/polyp. a Non-magnified view of chromoendoscopy with 0.05 % indigo carmine dye. A flat lesion, 7 mm in diameter, with mucus was seen in the ascending colon. b Magnified view of narrow-band imaging colonoscopy. The lesion showed the same color as the background, slightly thicker brown vessels, and a slightly irregular surface.
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FI180-2:  An example of a sessile serrated adenoma/polyp. a Non-magnified view of chromoendoscopy with 0.05 % indigo carmine dye. A flat lesion, 7 mm in diameter, with mucus was seen in the ascending colon. b Magnified view of narrow-band imaging colonoscopy. The lesion showed the same color as the background, slightly thicker brown vessels, and a slightly irregular surface.

Mentions: A total of 21 SSA/Ps were identified in 17 of 343 patients, and the prevalence of SSA/Ps, defined as the proportion of patients with ≥ 1 SSA/P, was 5.0 %. However, there was no SSA/P with cytological dysplasia in 343 patients (95 % confidence interval (CI): 0 – 0.9). Fig. 2 shows an example of an SSA/P identified and resected endoscopically in this study.


Prospective evaluation of the proportion of sessile serrated adenoma/polyps in endoscopically diagnosed colorectal polyps with hyperplastic features.

Sano W, Sano Y, Iwatate M, Hasuike N, Hattori S, Kosaka H, Ikumoto T, Kotaka M, Fujimori T - Endosc Int Open (2015)

 An example of a sessile serrated adenoma/polyp. a Non-magnified view of chromoendoscopy with 0.05 % indigo carmine dye. A flat lesion, 7 mm in diameter, with mucus was seen in the ascending colon. b Magnified view of narrow-band imaging colonoscopy. The lesion showed the same color as the background, slightly thicker brown vessels, and a slightly irregular surface.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554512&req=5

FI180-2:  An example of a sessile serrated adenoma/polyp. a Non-magnified view of chromoendoscopy with 0.05 % indigo carmine dye. A flat lesion, 7 mm in diameter, with mucus was seen in the ascending colon. b Magnified view of narrow-band imaging colonoscopy. The lesion showed the same color as the background, slightly thicker brown vessels, and a slightly irregular surface.
Mentions: A total of 21 SSA/Ps were identified in 17 of 343 patients, and the prevalence of SSA/Ps, defined as the proportion of patients with ≥ 1 SSA/P, was 5.0 %. However, there was no SSA/P with cytological dysplasia in 343 patients (95 % confidence interval (CI): 0 – 0.9). Fig. 2 shows an example of an SSA/P identified and resected endoscopically in this study.

Bottom Line: All of 21 SSA/Ps identified in 17 patients were included in E-HPs, and the overall proportion of SSA/Ps in E-HPs was 2.7 %.However, this proportion increased with the size of E-HPs (≤ 5 mm: 0.7 %; 6 - 9 mm: 29.0 %; ≥ 10 mm: 70 %) and was higher in the proximal colon than in the distal colorectum (10.9 % vs. 0.9 %).The overall proportion of SSA/Ps in E-HPs was 2.7 %, although this proportion was higher in the proximal colon and increased with the size of E-HPs.

View Article: PubMed Central - PubMed

Affiliation: Gastrointestinal Center, Sano Hospital, Hyogo, Japan.

ABSTRACT

Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) are considered precursors of colorectal cancers with microsatellite instability. However, it is still difficult to differentiate SSA/Ps from hyperplastic polyps endoscopically; therefore, the prevalence of SSA/Ps remains uncertain in clinical practice. This study aimed to clarify the proportion of SSA/Ps in endoscopically diagnosed colorectal polyps with hyperplastic features (E-HPs).

Patients and methods: Patients aged ≥ 40 years undergoing colonoscopy for standard clinical indications at our center were prospectively enrolled between June 2013 and May 2014. During colonoscopy, 0.05 % indigo carmine dye was sprayed throughout the colorectum to highlight lesions. All detected lesions were diagnosed by high definition magnifying narrow-band imaging and were resected endoscopically or surgically, apart from rectosigmoid E-HPs ≤ 5 mm. The number of rectosigmoid E-HPs ≤ 5 mm was recorded, and some were resected for use as tissue samples.

Results: A total of 343 patients (male: 42.9 %; mean age: 61.5 years) were included. Among 3838 E-HPs (distal: 96.4 %) detected in 294 patients, 792 were resected and analyzed. All of 21 SSA/Ps identified in 17 patients were included in E-HPs, and the overall proportion of SSA/Ps in E-HPs was 2.7 %. However, this proportion increased with the size of E-HPs (≤ 5 mm: 0.7 %; 6 - 9 mm: 29.0 %; ≥ 10 mm: 70 %) and was higher in the proximal colon than in the distal colorectum (10.9 % vs. 0.9 %). In addition, no SSA/P was found in the rectum, and no SSA/P had cytological dysplasia.

Conclusions: The overall proportion of SSA/Ps in E-HPs was 2.7 %, although this proportion was higher in the proximal colon and increased with the size of E-HPs. SSA/Ps were common in routine colonoscopy, with a prevalence of at least 5.0 %.

Study registration: UMIN000010832.

No MeSH data available.


Related in: MedlinePlus