PMID- 27663716
OWN - NLM
STAT- MEDLINE
DCOM- 20170928
LR  - 20170928
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 85
IP  - 3
DP  - 2017 Mar
TI  - Distinct endoscopic characteristics of sessile serrated adenoma/polyp with and
      without dysplasia/carcinoma.
PG  - 590-600
LID - S0016-5107(16)30587-9 [pii]
LID - 10.1016/j.gie.2016.09.018 [doi]
AB  - BACKGROUND AND AIMS: Sessile serrated adenoma/polyp (SSA/P) is a colorectal polyp
      that has malignant potential. However, the dysplastic components within an 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 cytologic dysplasia, and 7 with
      invasive carcinoma. We retrospectively studied the clinicopathologic and
      endoscopic characteristics and performed pit pattern analysis. RESULTS: A
      stepwise increase in the size of the SSA/P series was identified along with their
      dysplastic progression, although 19 of 48 (39.6%) SSA/Ps with dysplasia/carcinoma
      were </=10 mm in size. Most lesions were covered with a mucus cap.
      Macroscopically, (semi)pedunculated morphology, double elevation, central
      depression, and reddishness were found more frequently in SSA/P with cytologic
      dysplasia and invasive carcinoma ([semi]pedunculated morphology, 17.1%/28.6%;
      double elevation, 63.4%/57.1%; central depression, 9.8%/28.6%; reddishness,
      39.0%/85.7%) than in those without dysplasia (4.6%, 4.6%, 3.9%, and 3.4%,
      respectively). Furthermore, the presence of at least 1 of these 4 markers had
      high sensitivity (91.7%) for identifying the dysplasia/carcinoma within a SSA/P, 
      with a specificity of 85.3%. In the pit pattern analysis, all SSA/Ps without
      dysplasia exhibited type II pit pattern only, whereas 94.4% of SSA/Ps with
      dysplasia/carcinoma showed type II in addition to type IIIL, IV, VI, or VN pit
      patterns. CONCLUSIONS: In an SSA/P series, endoscopic characteristics, including 
      (semi)pedunculated morphology, double elevation, central depression, and
      reddishness, in addition to the use of magnifying endoscopy, may be useful to
      accurately diagnose advanced histology within an SSA/P.
CI  - Copyright (c) 2017 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Murakami, Takashi
AU  - Murakami T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo,
      Japan; Department of Human Pathology, Juntendo University School of Medicine,
      Tokyo, Japan.
FAU - Sakamoto, Naoto
AU  - Sakamoto N
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo,
      Japan.
FAU - Ritsuno, Hideaki
AU  - Ritsuno H
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo,
      Japan.
FAU - Shibuya, Tomoyoshi
AU  - Shibuya T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo,
      Japan.
FAU - Osada, Taro
AU  - Osada T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo,
      Japan.
FAU - Mitomi, Hiroyuki
AU  - Mitomi H
AD  - Department of Pathology, Japan Labor Health and Welfare Organization, Kanto Rosai
      Hospital, Kanagawa, Japan.
FAU - Yao, Takashi
AU  - Yao T
AD  - Department of Human Pathology, Juntendo University School of Medicine, Tokyo,
      Japan.
FAU - Watanabe, Sumio
AU  - Watanabe S
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo,
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20160920
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Adenoma/diagnosis/*pathology/surgery
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma/diagnosis/*pathology/surgery
MH  - Colonic Polyps/diagnosis/*pathology/surgery
MH  - *Colonoscopy
MH  - Colorectal Neoplasms/diagnosis/*pathology/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tumor Burden
EDAT- 2016/09/25 06:00
MHDA- 2017/09/29 06:00
CRDT- 2016/09/25 06:00
PHST- 2016/06/07 00:00 [received]
PHST- 2016/09/13 00:00 [accepted]
PHST- 2016/09/25 06:00 [pubmed]
PHST- 2017/09/29 06:00 [medline]
PHST- 2016/09/25 06:00 [entrez]
AID - S0016-5107(16)30587-9 [pii]
AID - 10.1016/j.gie.2016.09.018 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2017 Mar;85(3):590-600. doi: 10.1016/j.gie.2016.09.018. Epub
      2016 Sep 20.