Differentiation between sessile serrated adenoma/polyp and non-sessile serrated adenoma/polyp in large hyper plastic polyp: A Japanese collaborative study

Shida, Yohei; Ichikawa, Kazuhito; Fujimori, Takahiro; Fujimori, Yukari; Tomita, Shigeki; Fujii, Takeshi; Sano, Yasushi; Oda, Yasushi; Goto, Hiraaki; Ohta, Akihiko; Tanaka, Shinji; Sugai, Tamotsu; Yao, Takashi; Ohkura, Yasuo; Imura, Johji; Kato, Hiroyuki

doi:10.3892/mco.2012.20

Cited by 16 publications

(22 citation statements)

References 23 publications

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“…In this study, SSA / Ps were more often located in the proximal colon and were larger than HPs. These clinicopathological features are consistent with those reported previously 6,[15][16][17][18] .…”

Section: Discussionsupporting

confidence: 92%

Magnifying Colonoscopy Findings for Differential Diagnosis of Sessile Serrated Adenoma/Polyps and Hyperplastic Polyps

Toshihiro:筆頭著者

Yutaro:責任著者

Konishi

et al. 2016

Showa Univ J Med Sci

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: Sessile serrated adenoma / polyps SSA / Ps are thought to be precursors of colorectal cancers. However, current endoscopic techniques for differentiating SSA / Ps from conventional hyperplastic polyps HPs have low diagnostic accuracy. The aim of the present study was to assess the ability of mucosal crypt patterns to distinguish SSA / Ps from HPs. We examined 140 lesions from 93 patients that had been diagnosed histologically as SSA / Ps or HPs at the Showa University Hospital between June 2010 and May 2012. Three experienced colonoscopists reviewed the endoscopic ndings of magnifying colonoscopy. Type II open-shape Type II-O pit patterns and varicose microvascular vessels VMVs were identi ed according to previously proposed de nitions. Although 140 lesions were initially identi ed for the study, 27 lesions were excluded from analysis because of insuf cient endoscopic ndings. Thus, endoscopic ndings from a total of 113 lesions 68 SSA / Ps and 45 HPs were evaluated. Of 113 serrated polyps, 51 lesions 44 SSA / Ps and 7 HPs ; P 0.01 had Type II-O pit patterns. The inter-and intra-observer agreement for these patterns among three colonoscopists was 0.61 range 0.57-0.65 and 0.68 range 0.52-0.94 , respectively. The positive predictive value PPV , negative predictive value NPV , sensitivity, and speci city of Type II-O pit patterns for differentiating between SSA / P and HP were 86 , 61 , 65 , and 84 , respectively. In contrast, the PPV, NPV, sensitivity, and speci city of VMVs were 68 , 43 , 37 , and 73 , respectively. The results indicate that Type II-O mucosal crypt patterns may be useful for the differential diagnosis of SSAPs and HPs.

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Section: Discussionsupporting

confidence: 92%

Magnifying Colonoscopy Findings for Differential Diagnosis of Sessile Serrated Adenoma/Polyps and Hyperplastic Polyps

Toshihiro:筆頭著者

Yutaro:責任著者

Konishi

et al. 2016

Showa Univ J Med Sci

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“…When we compared SSA / Ps to non-SSA / Ps with a hyperplastic pattern, SSA / Ps were more often located in the proximal colon, had a super cial appearance, and were larger than non-SSA / Ps. These results are similar to those reported previously 4,[19][20][21][22] .…”

Section: Discussionsupporting

confidence: 83%

Accuracy of the Differential Diagnosis of Colorectal Serrated Polyps Using a Conventional Endoscope: A Prospective Study

Yanagisawa

Kubota

Konishi

et al. 2017

Showa Univ J Med Sci

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: Some serrated polyps SPs are thought to be precursors of colorectal cancers. However, the endoscopic diagnosis of sessile serrated adenoma / polyps SSA / Ps has been reported to have a low accuracy. The aim of this study was to clarify the ability to distinguish between SSA / Ps and non-SSA / Ps by using mucosal crypt patterns combined with endoscopic ndings. In total, 457 consecutive patients who underwent endoscopic resection for colorectal polyps at the Showa University Hospital from April 2007 to December 2010 were prospectively enrolled in this study. Before treatment, mucosal crypt patterns of the lesions were classi ed into three types hyperplastic, adenomatous, and mixed pattern . When the lesion had an adenomatous pattern with a cerebriform appearance or mixed pattern, it was diagnosed as a traditional serrated adenoma TSA . If the lesion had a hyperplastic pattern and was sized 6 mm or more in the proximal colon or 10 mm or more in the distal colon, it was diagnosed as an SSA / P by the endoscopist. We analyzed 1,151 colorectal polyps in this study. Endoscopically, 117 polyps were diagnosed as SSA / Ps or hyperplastic polyps HPs , 998 polyps were conventional adenomas, and 36 polyps were TSAs, with diagnostic accuracies of 94.7 , 94.1 , and 97.3 , respectively. Of the 117 polyps diagnosed as SSA / Ps or HPs, 59 lesions met our criteria for SSA / Ps, with a diagnostic accuracy of 70.9 . Our results indicate that the combination of mucosal crypt patterns and endoscopic findings may be useful for differentiating between SPs and non-SPs. However, additional speci c endoscopic features of SSA / Ps are still needed.

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“…The aim of this study was to evaluate whether this grading system can predict metastasis or recurrence, to validate the Ki67 index criteria of gastrointestinal NETs of the WHO 2010 classification, and to especially clarify the uncertainty in assessment of tumors with Ki67 index between 2—3%. We performed computer-assisted cytometrical analysis of Ki67 immunohistochemistry (IHC), which was established in several of our past studies [12,13], using the WinRooF image processing software (Mitani Corp., Tokyo, Japan).…”

Section: Introductionmentioning

confidence: 99%

Clinical validation of the gastrointestinal NET grading system: Ki67 index criteria of the WHO 2010 classification is appropriate to predict metastasis or recurrence

et al. 2013

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BackgroundIn the WHO 2010 classification, the neuroendocrine tumors (NETs) are subdivided by their mitotic index or Ki67 index into either G1 or G2 NETs. Tumors with a Ki67 index of <2% are classified as G1 and those with 3—20% are classified as G2. However, the assessment of tumors with Ki67 index of greater than 2% and less than or equal to 3% is still unclear. To resolve the problem, we validated the Ki67 index criteria of gastrointestinal NETs of the WHO 2010 classification.MethodsThe medical records of 45 patients who were pathologically diagnosed as having NET G1/G2 of the gastrointestinal tract were analyzed retrospectively. According to the WHO 2010 classification, Ki67 index were calculated. Computer-assisted cytometrical analysis of Ki67 immunoreactivity was performed using the WinRooF image processing software. Receiver operating characteristic (ROC) curves were generated to determine the best discriminating Ki67 index. To clarify the assessment of tumors with Ki67 index between 2—3%, the calculated cutoff of Ki67 index was evaluated using Fisher’s exact test.ResultsROC curve analysis confirmed that 2.8% was the best Ki67 index cutoff value for predicting metastasis or recurrence. The sensitivity of the new Ki67 index cutoff was 42.9%, and the specificity was 86.8%.ConclusionsDivision of NETs into G1/G2 based on Ki67 index of 3% was appropriate to predict metastases or recurrences. The WHO grading system may be the most useful classification to predict metastases or recurrences.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1553036118943799

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Differentiation between sessile serrated adenoma/polyp and non-sessile serrated adenoma/polyp in large hyper plastic polyp: A Japanese collaborative study

Cited by 16 publications

References 23 publications

Magnifying Colonoscopy Findings for Differential Diagnosis of Sessile Serrated Adenoma/Polyps and Hyperplastic Polyps

Magnifying Colonoscopy Findings for Differential Diagnosis of Sessile Serrated Adenoma/Polyps and Hyperplastic Polyps

Accuracy of the Differential Diagnosis of Colorectal Serrated Polyps Using a Conventional Endoscope: A Prospective Study

Clinical validation of the gastrointestinal NET grading system: Ki67 index criteria of the WHO 2010 classification is appropriate to predict metastasis or recurrence

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