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Serrated polyp

Elmire Hartmans, Jolien J J Tjalma, Matthijs D Linssen, Pilar Beatriz Garcia Allende, Marjory Koller, Annelies Jorritsma-Smit, Mariana E Silva de Oliveira Nery, Sjoerd G Elias, Arend Karrenbeld, Elisabeth G E de Vries, Jan H Kleibeuker, Gooitzen M van Dam, Dominic J Robinson, Vasilis Ntziachristos, Wouter B Nagengast
Adenoma miss rates in colonoscopy are unacceptably high, especially for sessile serrated adenomas / polyps (SSA/Ps) and in high-risk populations, such as patients with Lynch syndrome. Detection rates may be improved by fluorescence molecular endoscopy (FME), which allows morphological visualization of lesions with high-definition white-light imaging as well as fluorescence-guided identification of lesions with a specific molecular marker. In a clinical proof-of-principal study, we investigated FME for colorectal adenoma detection, using a fluorescently labelled antibody (bevacizumab-800CW) against vascular endothelial growth factor A (VEGFA), which is highly upregulated in colorectal adenomas...
2018: Theranostics
Hironori Aoki, Eiichiro Yamamoto, Hiro-O Yamano, Tamotsu Sugai, Tomoaki Kimura, Yoshihito Tanaka, Hiro-O Matsushita, Kenjiro Yoshikawa, Ryo Takagi, Eiji Harada, Michiko Nakaoka, Yuko Yoshida, Taku Harada, Gota Sudo, Makoto Eizuka, Akira Yorozu, Hiroshi Kitajima, Takeshi Niinuma, Masahiro Kai, Masanori Nojima, Hiromu Suzuki, Hiroshi Nakase
BACKGROUND: Colorectal serrated lesions (SLs) are important premalignant lesions whose clinical and biological features are not fully understood. AIMS: We aimed to establish accurate colonoscopic diagnosis and treatment of SLs through evaluation of associations among the morphological, pathological, and molecular characteristics of SLs. METHODS: A total of 388 premalignant and 18 malignant colorectal lesions were studied. Using magnifying colonoscopy, microsurface structures were assessed based on Kudo's pit pattern classification system, and the Type II pit pattern was subcategorized into classical Type II, Type II-Open (Type II-O) and Type II-Long (Type II-L)...
March 15, 2018: Digestive Diseases and Sciences
Tianyu Liu, Duochen Jin, Samiullah Khan, Xue Chen, Tao Shi, Wenxiao Dong, Yanrong Qi, Zixuan Guo, Bangmao Wang, Hailong Cao
OBJECTIVE: A growing body of evidence indicates that patients with colorectal serrated lesions especially advanced serrated lesions (ASLs) are at risk of subsequent malignancy. This study aimed to provide more information for endoscopists for the management of ASLs by analyzing the clinicopathological features of ASLs, and the association between the presence of ASL and synchronous advanced colorectal neoplasia (sACN) in China. METHODS: We performed a retrospective cross-sectional study of data from 38,981 symptomatic patients who underwent colonoscopy between January 2010 and March 2016...
March 15, 2018: Journal of Digestive Diseases
Silvia Paggi, Giuseppe Mogavero, Arnaldo Amato, Emanuele Rondonotti, Alida Andrealli, Gianni Imperiali, Nicoletta Lenoci, Giovanna Mandelli, Natalia Terreni, Francesco Simone Conforti, Dario Conte, Giancarlo Spinzi, Franco Radaelli
BACKGROUND:  Linked color imaging (LCI) is a newly developed image-enhancing endoscopy technology that provides bright endoscopic images and increases color contrast. We investigated whether LCI improves the detection of neoplastic lesions in the right colon when compared with high definition white-light imaging (WLI). METHODS:  Consecutive patients undergoing colonoscopy were randomized (1:1) after cecal intubation into right colon inspection at first pass by LCI or by WLI...
March 14, 2018: Endoscopy
Daisaku Fujimoto, Naoki Muguruma, Koichi Okamoto, Yasuteru Fujino, Kaizo Kagemoto, Yasuyuki Okada, Yoshifumi Takaoka, Yasuhiro Mitsui, Shinji Kitamura, Tetsuo Kimura, Hiroshi Miyamoto, Yoshimi Bando, Tomoko Sonoda, Tetsuji Takayama
Background and study aims:  Although new image-enhanced endoscopy (IEE) technologies such as blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI) have been developed, their utility for the detection of sessile serrated adenoma/polyps (SSA/Ps) is still unclear. This study aimed to evaluate the utility of BLI, BLI-bright, and LCI for SSA/P detection in still image examinations and in a prospective randomized controlled trial (RCT). Patients and methods:  A group of 6 expert and non-expert endoscopists read 200 endoscopic still images containing SSA/P lesions using white light image (WLI), BLI, BLI-bright, and LCI...
March 2018: Endoscopy International Open
Akihiro Ito, Tomoaki Suga, Hiroyoshi Ota, Nobuyuki Tateiwa, Akihiro Matsumoto, Eiji Tanaka
BACKGROUND: Cold snare polypectomy (CSP) has not undergone sufficient histopathological evaluation. This study aimed to clarify the histopathological features of CSP specimens, including resection depth and layer, as compared with endoscopic mucosal resection (EMR). METHODS: Polyps were recruited retrospectively. Sessile, semi-pedunculated, and 0-IIa polyps of ≤ 9 mm were selected by propensity score matching and classified as either a complete resection or one with an unevaluable/positive (X/+) margin...
March 7, 2018: Journal of Gastroenterology
Abimbola Adike, Matthew R Buras, Suryakanth R Gurudu, Jonathan A Leighton, Douglas O Faigel, Kevin C Ruff, Sarah B Umar, Francisco C Ramirez
Background: The impact of Boston bowel preparation scale (BBPS) scores on the adenoma detection rate (ADR) in each segment has not been adequately addressed. The aim of this study was to determine the association between segmental or overall ADR and serrated polyp detection rate (SDR) with segmental and total BBPS scores. Methods: All outpatient screening colonoscopies with documented BBPS scores were retrospectively reviewed at a tertiary institution from January to December 2013...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Seth D Crockett, Elizabeth L Barry, Leila A Mott, Dennis J Ahnen, Douglas J Robertson, Joseph C Anderson, Kristen Wallace, Carol A Burke, Robert S Bresalier, Jane C Figueiredo, Dale C Snover, John A Baron
OBJECTIVE: Serrated lesions such as sessile serrated adenomas or polyps (SSA/Ps) are important colorectal cancer precursors, but aetiological factors for these lesions are largely unknown. We aimed to determine the effects of calcium and vitamin D supplementation on the incidence of serrated polyps (SPs) in general and hyperplastic polyps and SSA/Ps specifically. DESIGN: Participants with one or more adenoma at baseline were randomised to receive 1200 mg/day of elemental calcium, 1000 IU/day of vitamin D3 , both or neither agent...
March 1, 2018: Gut
Alyssa M Parian, Mark G Lazarev
The serrated neoplasia pathway is thought to account for up to 30% of sporadic colorectal cancer, but its role in inflammatory bowel disease (IBD)-related colorectal cancer is still not well elucidated. Hyperplastic polyps are not thought to impart an increased risk of colorectal cancer; however, sessile serrated adenomas/polyps and traditional serrated adenomas may have malignant potential. From the limited research currently available, this appears to hold true for IBD patients as well. IBD patients do not seem to be at a higher risk of typical serrated colorectal lesions than the general population, but it is still not known if they have a quicker progression to colorectal cancer...
January 2018: Gastroenterology & Hepatology
Mohamad A Mouchli, Lidia Ouk, Marianne R Scheitel, Alisha P Chaudhry, Donna Felmlee-Devine, Diane E Grill, Shahrooz Rashtak, Panwen Wang, Junwen Wang, Rajeev Chaudhry, Thomas C Smyrk, Ann L Oberg, Brooke R Druliner, Lisa A Boardman
AIM: To determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS: Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study...
February 28, 2018: World Journal of Gastroenterology: WJG
(no author information available yet)
No abstract text is available yet for this article.
March 2018: Endoscopy
Arvind J Trindade, Arvind Rishi, Robert Hirten, Sumant Inamdar, Divyesh V Sejpal, Jean-Frederic Colombel
BACKGROUND AND AIMS: There is limited data on the use of volumetric laser endomicroscopy (VLE) in imaging for colon polyps. Our aim was to identify VLE features of colon polyps. METHODS: A total of 45 patients were included. 43 underwent endoscopic mucosal resection of colorectal polyps 2 cm or greater. These polyps were then scanned with VLE immediately after resection. Two patients that underwent partial colonic resection served as controls. RESULTS: Forty-three polyps were included with review of matching histology: 3 intramucosal adenocarcinoma (IMCA), 5 tubular adenoma (TA)/tubulovillous adenoma (TVA) with high-grade dysplasia (HGD), 9 TVA with only low-grade dysplasia (LGD), 5 serrated adenoma (SA), and 21 TA with LGD...
February 22, 2018: Gastrointestinal Endoscopy
Eugene Kligman, Wenfang Li, George J Eckert, Charles Kahi
BACKGROUND AND AIMS: The adenoma detection rate (ADR) is a powerful measure of screening colonoscopy quality. Patients who undergo colonoscopy for the evaluation of a positive fecal immunochemical test (FIT) have increased prevalence of colorectal neoplasia, but it is not known whether separate quality benchmarks are required. The aim of this study was to compare the conventional ADR to the ADR of colonoscopies performed for the evaluation of positive FIT, in asymptomatic average-risk patients...
February 22, 2018: Digestive Diseases and Sciences
Abraham Christoffel van Wyk, Hennie van Zyl, Jonathan Rigby
BACKGROUND: Colorectal perineuriomas are uncommon benign mucosal-based proliferations of mesenchymal cells that express perineurial markers, often associated with colonic crypts displaying a serrated/hyperplastic architecture. The vast majority of cases arise distal to the splenic flexure and have been described as sessile polyps. Using molecular analysis, BRAF mutations have been demonstrated in the serrated crypt epithelium. We report a new case of perineurioma presenting as a pedunculated polyp in the transverse colon, with prominent hemosiderin deposits in the uninvolved lamina propria that separated the perineurial proliferation from the surface epithelium, a previously unreported histological finding...
February 20, 2018: Diagnostic Pathology
N A Oleynikova, O A Kharlova, P G Malkov, N V Danilova
AIM: the evaluation of Ki-67 and CD44 expression in the 'serrated' polyps of the colon and comparison them with adenocarcinomas and tubular and tubule-villous adenomas of the colon. MATERIAL AND METHODS: The study is including 49 'serrated' polyps, 34 tubular (AT) and tubulo-villous (ATV) adenomas and 32 adenocarcinomas of the colon. Antibodies CD44 and Ki-67 were used as immunohistochemical markers in this study. RESULTS: A statistically significant difference (p<0...
2018: Arkhiv Patologii
Claire Fan, Adam Younis, Christine E Bookhout, Seth D Crockett
PURPOSE OF REVIEW: The purpose of this review is to summarize the management of serrated colorectal polyps (SPs), with a particular focus on the most common premalignant SP, sessile serrated adenoma or polyp (SSA/P). These lesions present a challenge for endoscopists with respect to detection and resection, and are also susceptible to pathologic misdiagnosis. RECENT FINDINGS: Patients with SSA/Ps are at an increased risk of future colorectal neoplasia, including advanced polyps and cancer...
February 14, 2018: Current Treatment Options in Gastroenterology
Hironori Aoki, Eiichiro Yamamoto, Akira Takasawa, Takeshi Niinuma, Hiro-O Yamano, Taku Harada, Hiro-O Matsushita, Kenjiro Yoshikawa, Ryo Takagi, Eiji Harada, Yoshihito Tanaka, Yuko Yoshida, Tomoyuki Aoyama, Makoto Eizuka, Akira Yorozu, Hiroshi Kitajima, Masahiro Kai, Norimasa Sawada, Tamotsu Sugai, Hiroshi Nakase, Hiromu Suzuki
Colorectal sessile serrated adenoma/polyps (SSA/Ps) are well-known precursors of colorectal cancer (CRC) characterized by BRAF mutation and microsatellite instability. By contrast, the molecular characteristics of traditional serrated adenoma (TSAs) are not fully understood. We analyzed genome-wide DNA methylation in TSAs having both protruding and flat components. We identified 11 genes, including SMOC1 , methylation of which progressively increased during the development of TSAs. SMOC1 was prevalently methylated in TSAs, but was rarely methylated in SSA/Ps ( p < 0...
January 12, 2018: Oncotarget
Kun Hu, Shiqian Shen, Lanjing Zhang
Presence of colonic crypts in submucosa was previously termed as herniation of crypts, pseudoinvasion, epithelial-misplacement, or inverted hyperplastic-polyp. It is considered as an important criterion for diagnosing sessile serrated adenoma (SSA), which links to a higher risk of synchronous and future colorectal cancers compared with hyperplastic polyp (HP). Here, we aimed to study the frequencies, diagnostic specificity and synchronous neoplasms of herniation of crypts in HP and SSA. We prospectively included all HP and SSA cases and 514 randomly-selected colorectal polyps of normal histology diagnosed from 2013 to 2015 at our institution...
2018: American Journal of Cancer Research
Hyun-Soo Kim, Ho Yeon Jung, Hong Jun Park, Hee Man Kim, Jae Ho Seong, Yong Seok Kang, Mee Yon Cho, Min Heui Yu, Dae Ryong Kang
BACKGROUND: /Aim: The criterion standard polypectomy technique for the complete removal of small colorectal polyps has not yet been established. This study aimed to compare the complete resection rate of hot snare polypectomy (HSP) with that of endoscopic mucosal resection (EMR) for small, sessile, or flat polyps. METHODS: Patients with 5-9-mm non-pedunculated colorectal polyps were prospectively randomized to the HSP or EMR group. The presence of residual polyps was assessed by performing histological assessment of 4-quadrant forceps biopsies taken from the edges of the polypectomy site...
February 1, 2018: Gastrointestinal Endoscopy
Seong Ho Park, David H Kim
This article outlines how to achieve maximum accuracy in interpreting CT colonography (CTC) regarding colonic findings. Interpreting extracolonic findings seen on CTC is a separate diagnostic task and will not be addressed in this article. While many interpretive pitfalls are in fact related to CTC techniques, this article focuses on issues that are related to interpretive knowledge and skills, avoiding in-depth discussions on CTC techniques. Principal methods and further tips for detecting possible polyp candidates and for confirming true soft-tissue polyps will be discussed...
February 5, 2018: Abdominal Radiology
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