Endoscopic features of sessile serrated adenomas: validation by international experts using high-resolution white-light endoscopy and narrow-band imaging

Hazewinkel, Yark; López-Cerón, María; East, James E.; Rastogi, Amit; Pellisé, María; Nakajima, Takeshi; Eeden, Susanne van; Tytgat, Kristien M. A. J.; Fockens, Paul; Dekker, Evelien

doi:10.1016/j.gie.2012.12.018

Cited by 185 publications

(196 citation statements)

References 26 publications

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“…Upon endoscopy, SSA/Ps are sessile and often yellow, covered by a tenacious mucus cap that needs to be moved to allow adequate visualization [43]. An indistinct border with a rim of debris or bubbles, a cloud-like surface with alteration of mucosal fold contour, and interruption of the underlying mucosal vascular pattern are other typical findings [48,49]. Nevertheless, most SSA/Ps are subtle and can thus easily be missed, particularly by an endoscopist who is not experienced in recognizing the minute changes that may indicate the presence of a lesion.…”

Section: Serrated Lesionsmentioning

confidence: 99%

Serrated and Non-Serrated Precursor Lesions of Colorectal Cancer

Langner¹

2014

Dig Dis

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Although often viewed as a single disease, colorectal cancer more accurately represents a family of diseases with different precursor lesions. Conventional (tubular, tubulovillous and villous) adenomas are the most common neoplastic lesions occurring in the large intestine. They have adenomatous polyposis coli (APC) mutations and arise from dysplastic aberrant crypt foci, initially as polyclonal lesions. In sporadic tumours, neoplastic progression follows the traditional pathway (chromosomal instability pathway), resulting in CpG island methylator phenotype (CIMP)-negative, microsatellite-stable (MSS), BRAF and KRAS wild-type cancers. Germline mutations in the APC gene lead to familial adenomatous polyposis. Conventional adenomas are also the precursors of Lynch syndrome-associated microsatellite-instable (MSI-high) cancers. Sessile serrated adenoma/polyp (SSA/P) is the principal precursor lesion of the serrated pathway, in which BRAF mutation can lead to colorectal cancer with MSI-high CIMP-high or MSS CIMP-high phenotype. SSA/Ps have been associated with synchronous and metachronous invasive adenocarcinomas as well as so-called interval carcinomas. Serrated polyposis is rare but most likely underdiagnosed. Affected individuals bear an increased but unspecified risk for the development of colorectal cancer; close endoscopic surveillance is warranted. Traditional serrated adenomas (TSAs) are much less common than the other serrated lesions. Cancers originating from TSAs may show KRAS mutation with a CIMP-high MSS phenotype.

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Section: Serrated Lesionsmentioning

confidence: 99%

Serrated and Non-Serrated Precursor Lesions of Colorectal Cancer

Langner¹

2014

Dig Dis

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“…Serrated lesions (SSA/P and larger hyperplastic polyps) may be incompletely resected because the color of the lesions is similar to the surrounding mucosa, and the edges are indistinct 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Recurrence rates after EMR of large sessile serrated polyps

Rex

Vemulapalli

Rex

2015

Gastrointestinal Endoscopy

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“…17 When incorporating these features in the prediction of SSA, we found them to be acceptably accurate. Our study is the largest to date to accurately assess SSAs with the NBI-NF with a high accuracy, having been previously demonstrated by Singh et al 27 A larger study by Vu et al 28 incorporated serrated polyps into their study but did not achieve the accuracy required by the PIVI statements.…”

Section: Discussionmentioning

confidence: 84%

“…16 The SSA is easily overlooked at colonoscopy because it is often flat and colorless, may be obscured by suboptimal preparation, and can be mistaken for hyperplastic polyps to the untrained eye. 17 This is despite some definitive endoscopic characteristics including the mucous cap 4 or a rim of debris and bubbles around the polyp. 18,19 It remains to be seen whether NBI with or without zoom maintains its accuracy when used in the detection of serrated lesions.…”

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confidence: 99%