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Sessile serrated adenoma

Cristina Oana Mărginean, Maria Oana Mărginean, Iunius Simu, Adrienne Horvath, Lorena Elena Meliţ
BACKGROUND: Adenomas of the colon are usually benign tumors which carry a tendency for malignancy. These tumors can be villous, tubular, tubulovillous, or sessile serrated. Those with adenomatous structure can develop malignant characteristics in 1.5% to 9.4% of cases. METHODS: We present a case report of a 16-year-old female adolescent with an adenoma of the descending colon. History revealed prolonged diarrheic syndrome for the past 6 months, repeated headache, and a weight loss of ∼5 kg in the past month...
October 2016: Medicine (Baltimore)
Hai-Long Cao, Xue Chen, Shao-Chun Du, Wen-Jing Song, Wei-Qiang Wang, Meng-Que Xu, Si-Nan Wang, Mei-Yu Piao, Xiao-Cang Cao, Bang-Mao Wang
BACKGROUND: Colorectal serrated polyp is considered as histologically heterogeneous lesions with malignant potential in western countries. However, few Asian studies have investigated the comprehensive clinical features of serrated polyps in symptomatic populations. The aim of the study was to evaluate the features of colorectal serrated polyps in a Chinese symptomatic population. METHODS: Data from all consecutive symptomatic patients were documented from a large colonoscopy database and were analyzed...
2016: Chinese Medical Journal
Eugenia Shmidt, Vandana Nehra, Val Lowe, Amy S Oxentenko
BACKGROUND: The frequency and clinically important characteristics of incidental (18)F-fluorodeoxyglucose ([18 F]FDG) positron emission tomography (PET) uptake in the gastrointestinal tract (GIT) on PET/CT imaging in adults remain elusive. METHODS: All PET/CT reports from 1/1/2000 to 12/31/2009 at a single tertiary referral center were reviewed; clinical information was obtained from cases with incidental (18)F-FDG uptake in the GIT, with follow-up through October, 2012...
October 6, 2016: BMC Gastroenterology
Shiv Ram Krishn, Sukhwinder Kaur, Yuri M Sheinin, Lynette M Smith, Shailendra K Gautam, Asish Patel, Maneesh Jain, Vasthala Juvvigunta, Priya Pai, Audrey J Lazenby, Hemant K Roy, Surinder K Batra
Sessile serrated adenoma/polyps (SSA/P) are premalignant lesions of colorectal cancer that are difficult to distinguish histologically from hyperplastic polyps (HP) of minimal to no malignant potential. Specific markers for differentiating SSA/P from HP can aid clinicians for optimizing colon surveillance intervals. The present study investigates the potential of mucins and associated O-glycans to distinguish SSA/P from HP. Expression of colonic mucins (MUC1, MUC4, MUC17, MUC2, and MUC5AC) and O-glycans [Sialyl LewisA (CA19-9) and Tn/Sialyl-Tn on MUC1] were analyzed in HP (n=33), SSA/P (n=39), and tubular adenoma (TA) (n=36) samples by immunohistochemistry...
September 29, 2016: Oncotarget
Eun-Young Karen Choi, Henry D Appelman
This article offers a historical perspective on the discovery of 3 types of serrated colorectal polyps recognized in the past 60 years. The first to be discovered was the hyperplastic polyp, which is still the most commonly encountered serrated polyp. In the past 20 years, the carcinoma-associated sessile serrated adenoma/polyp has been recognized, but its diagnosis can be difficult owing to overlapping histologic features with hyperplastic polyps. Less is known about the third type, the traditional serrated adenoma, because it is far less common than the other 2 types, and its association with cancer is currently under investigation...
October 2016: Archives of Pathology & Laboratory Medicine
Rajvinder Singh, Leonardo Zorrón Cheng Tao Pu, Doreen Koay, Alastair Burt
It is currently known that colorectal cancers (CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway (50%-70%); the mutator "Lynch syndrome" route (3%-5%); and the serrated pathway (30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps (HP), sessile serrated adenomas/polyps (SSA/P) and traditional serrated adenomas (TSA), the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare...
September 14, 2016: World Journal of Gastroenterology: WJG
Takashi Murakami, Naoto Sakamoto, Hideaki Ritsuno, Tomoyoshi Shibuya, Taro Osada, Hiroyuki Mitomi, Takashi Yao, Sumio Watanabe
BACKGROUND AND AIMS: Sessile serrated adenoma/polyp (SSA/P) is a colorectal polyp that possesses malignant potential. However, the dysplastic components within a SSA/P can be difficult to detect. This study aimed to clarify the endoscopic characteristics of SSA/P with advanced histology. METHODS: We examined 462 endoscopically or surgically resected lesions that were pathologically diagnosed as SSA/P, including 414 without and 41 with cytological dysplasia, and 7 with invasive carcinoma...
September 20, 2016: Gastrointestinal Endoscopy
Vassiliki L Tsikitis, Aimee Potter, Motomi Mori, Julie A Buckmeier, Christina R Preece, Chris A Harrington, Angela N Bartley, Achyut Bhattacharyya, Stanley R Hamilton, Peter Lance, Patricia A Thompson
Colorectal cancer (CRC) and adenoma adjacent to cancer exhibit distinct microRNA (miR) alterations in an apparent mucosa-to-adenocarcinoma sequence. The pattern of microRNAs in screen-detected polyps in relation to histologic features and cancer risk has not been investigated. miR expression analysis was performed on normal mucosa (NM), hyperplastic polyps (HPs), tubular adenomas (TAs), tubulovillous adenomas or high-grade dysplasia (TVHGs), and serrated polyps (sessile serrated adenoma/polyps, SSA/Ps, and traditional serrated adenomas, TSAs) in biopsy specimens from 109 patients undergoing screening/surveillance colonoscopy...
September 22, 2016: Cancer Prevention Research
Hyo-Joon Yang, Jeong In Lee, Soo-Kyung Park, Yoon Suk Jung, Jin Hee Sohn, Kyu Yong Choi, Dong Il Park
Background/Aims: It is unclear whether the endoscopic features of sessile serrated adenomas (SSAs) would be useful to trainee colonoscopists to predict SSA. Therefore, the present study aimed to identify features that expert and trainee colonoscopists can use to independently and reliably predict SSA by using high-resolution white-light endoscopy. Methods: Endoscopic images of 81 polyps (39 SSAs, 22 hyperplastic polyps, and 20 tubular adenomas) from 43 patients were retrospectively evaluated by 10 colonoscopists (four experts and six trainees)...
September 13, 2016: Clinical Endoscopy
Lesley Bailie, Maurice B Loughrey, Helen G Coleman
BACKGROUND & AIMS: Certain subsets of colorectal serrated polyps (SP) have malignant potential. We performed a systematic review and meta-analysis to investigate the association between modifiable lifestyle factors and risk for SPs. METHODS: We conducted a systematic search of Medline, Embase, and Web of Science, for observational or interventional studies that contained the terms risk or risk factor, and serrated or hyperplastic, and polyps or adenomas, and colorectal (or synonymous terms), published by March 2016...
September 14, 2016: Gastroenterology
Yiwei Wang, Dan Huang, Kai-Yuan Chen, Min Cui, Weihuan Wang, Xiaoran Huang, Amad Awadellah, Qing Li, Ann Friedman, William W Xin, Luca Di Martino, Fabio Cominelli, Alex Miron, Ricky Chan, James Fox, Yan Xu, Xiling Shen, Mathew F Kalady, Sanford Markowitz, Ivan Maillard, John B Lowe, Wei Xin, Lan Zhou
BACKGROUND & AIMS: De novo synthesis of GDP-fucose, a substrate for fucosylglycans, requires sequential reactions mediated by GDP-mannose 4,6-dehydratase (GMDS) and GDP-4-keto-6-deoxymannose 3,5-epimerase-4-reductase (FX or TSTA3). GMDS deletions and mutations are found in 6%-13% of colorectal cancers; these mostly affect ascending and transverse colon. We investigated whether lack of fucosylation consequent to loss of GDP-fucose synthesis contributes to colon carcinogenesis. METHODS: FX deficiency and GMDS deletion produce the same biochemical phenotype of GDP-fucose deficiency...
September 14, 2016: Gastroenterology
Sarah K McGill, Roy Soetikno, Robert V Rouse, Hobart Lai, Tonya Kaltenbach
BACKGROUND & AIMS: Nonpolypoid colorectal neoplasms (NP-CRNs) are more likely to contain high-grade dysplasia or early-stage cancer than polypoid neoplasms. We aimed to determine the long-term outcomes of patients with at least 1 NP-CRN. METHODS: We performed a longitudinal cohort study of 4454 patients at a Veterans' Affairs hospital who underwent colonoscopy from 2000 through 2005; 341 were found to have 1 or more NP-CRNs and were matched (3:1) with patients found to have 1 or more polypoid neoplasms (controls, n = 1025)...
September 14, 2016: Clinical Gastroenterology and Hepatology
T Rau
The pathogenesis of precursor lesions of gastrointestinal tumors is manifested in many ways. In the esophagus an aberrant genetic expression of intestinal transcription factors, such as CDX2 is initiated by local environment factors. During the subsequent dysplasia to carcinoma sequence, chromosomal gain and loss of genes occurs. A 4-color fluorescence in situ hybridization (FISH) assay can be applied in dysplasia as well as in Barrett's adenocarcinoma to define prognostic marker combinations. In the gastric carcinogenesis sequence the gene expression of CDX1 is regulatively dependent on an interplay between inflammation and promotor methylation...
September 14, 2016: Der Pathologe
Joshua Melson, Daniel Berger, Michael Greenspan, Mohamed Bayoumi, Shriram Jakate
BACKGROUND AND AIMS: Non-neoplastic polypectomies (NNP) add pathology and procedural costs but do not reduce cancer risk and should be minimized. We sought to define the minimal non-neoplastic polypectomy rate for those colonoscopists achieving high-quality colorectal cancer screening based on adenoma detection rates. METHODS: Non-neoplastic polypectomy rates (NNPR) for colonoscopists achieving high-quality adenoma detection rates (ADR) were reported to determine minimal NNPR goals...
September 2, 2016: Gastrointestinal Endoscopy
Ali Zare Mirzaie, Hakimeh Khakpour, Masoud Mireskandari, Nasrin Shayanfar, Ladan Fatahi
BACKGROUND: The purpose of this study was to determine the frequency of Serrated polyps of colonic polyps samples in Hazrat_e Rasoul_e Akram Hospital over ten years. MATERIALS: The target group in this study was patients with colonic polyps in Hazrat_e Rasoul_e Akram Hospital. Pathologic evaluation of these patients was done. Serrated polyps, by location, gender, age and type of polyps were divided and frequency of them were determined separately. RESULTS: Of 381 patients studied, 224 (58...
June 2016: Medical Archives
Thomas F Imperiale, Menggang Yu, Patrick O Monahan, Timothy E Stump, Rebeka Tabbey, Elizabeth Glowinski, David F Ransohoff
BACKGROUND: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute's (NCI's) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. METHODS: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy...
January 2017: Journal of the National Cancer Institute
Badr Al-Bawardy, Elizabeth Rajan, Louis M Wong Kee Song
BACKGROUND AND AIMS: Endoscopic full-thickness resection (EFTR) allows for definitive diagnosis and treatment of select subepithelial and epithelial lesions unsuitable to conventional resection techniques. Our aim was to evaluate the efficacy and safety of over-the-scope (OTS) clip-assisted EFTR for these lesions. METHODS: Patients who underwent OTS clip-assisted EFTR between June 2014 and October 2015 were analyzed. The procedure involved (1) thermal marking of the periphery of the lesion; (2) lesion suction into the cap of either an OTSC (Ovesco Endoscopy AG, Tübingen, Germany) or Padlock clip (Aponos Medical Corp, Kingston, NH, USA) with or without triprong anchor retraction of the lesion; (3) clip deployment; and (4) en bloc resection of the lesion above the clip using an electrosurgical snare and/or knife...
August 26, 2016: Gastrointestinal Endoscopy
Dilshan Udayasiri, Paul Hollington
BACKGROUND: Colonoscopic surveillance following potentially curative surgery for colorectal cancer aims to detect treatable metachronous neoplasia. The timing and findings of colonoscopies for patients enrolled in an endoscopic surveillance programme were examined in this study. METHODS: A retrospective clinical audit was undertaken of 174 consecutive patients undergoing surgery for first-presentation colorectal cancer, looking at the findings of subsequent surveillance colonoscopies...
August 26, 2016: ANZ Journal of Surgery
Neil D Parikh, Joanna Gibson, Anil Nagar, Ali A Ahmed, Harry R Aslanian
BACKGROUND AND AIMS: Sessile serrated adenomas/polyps (SSA/Ps) are difficult to differentiate from non-neoplastic tissue on white-light endoscopy. Confocal laser endomicroscopy (CLE) provides subcellular imaging and real-time "optical biopsy". The aim of this study was to prospectively describe CLE features of SSA/Ps. PATIENTS AND METHODS: Consecutive patients with SSA/Ps were prospectively evaluated with probe-based CLE imaging. CLE images and polyp histology were independently reviewed by three endoscopists and an expert gastrointestinal (GI) pathologist...
August 2016: United European Gastroenterology Journal
Arnaldo Amato, Franco Radaelli, Giancarlo Spinzi
BACKGROUND: Underwater endoscopic mucosal resection without submucosal injection has been described for removing large flat colorectal lesions. OBJECTIVE: We aim to evaluate the reproducibility of this technique in terms of ease of implementation, safety and efficacy. METHODS: A prospective observational study of consecutive underwater endoscopic mucosal resection in a community hospital was performed. RESULTS: From September 2014 to April 2015, 25 flat or sessile colorectal lesions (median size 22...
August 2016: United European Gastroenterology Journal
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