Flat Adenomas in the United Kingdom: Are Treatable Cancers Being Missed?

Fujii, Takeshi; Rembacken, Björn; Dixon, M. F.; Yoshida, S; Axon, A. T. R.

doi:10.1055/s-2007-1001304

Cited by 195 publications

(102 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is likely that the biologic behaviour of NPG carcinomas is more aggressive than that of PG carcinomas. Many reports have analysed that flat and depressed lesions have a higher malignant potential than polypoid lesions, since flat and depressed lesions readily infiltrate deeper layers despite their small size (Crowford and Stromeyer, 1983;Wolber and Owen, 1991;Lanspa et al, 1992;Jaramillo et al, 1994;Rubio et al, 1994;Kudo et al, 1995a, b;Mitooka et al, 1995;Yokota et al, 1995;Fujii et al, 1998;Hart et al, 1998;Rembacken et al, 2000;Saito et al, 2001). A greater malignant potential in NPG carcinomas than in PG carcinomas is analogous to flat lesions containing depressed areas having greater malignant potential than polypoid adenomas.…”

Section: Discussionmentioning

confidence: 99%

Pathological features and genetic alterations in colorectal carcinomas with characteristics of nonpolypoid growth

Kaneko¹,

Kurahashi²,

Makino³

et al. 2004

Br J Cancer

View full text Add to dashboard Cite

We sought to clarify pathological features and genetic alterations in colorectal carcinomas with characteristics of nonpolypoid growth. Colorectal carcinomas resected at Showa University Hospital in Tokyo included 86 with characteristics of polypoid growth (PG) and 21 with those of nonpolypoid growth (NPG). Mutations of APC, Ki-ras, and p53 genes, as well as microsatellite instability (MSI), were analysed using fluorescence-based polymerase chain reaction -single-strand conformation polymorphism (PCR -SSCP). Carcinomas with an NPG pattern were smaller than PG tumours (Po0.0001). Carcinomas with a PG pattern were more likely to harbour Ki-ras mutations (36%) than NPG tumours (0%; Po0.0001). Mutation types in the APC gene differed significantly between PG and NPG carcinomas (P ¼ 0.0189), including frameshift mutations in 66% of PG carcinomas but no NPG carcinomas. Presence of a p53 mutation at a 'hot spot' also was more likely in PG carcinomas (37%) than in NPG carcinomas (0%; P ¼ 0.0124). No significant difference in presence of MSI was evident between carcinomas with PG and NPG patterns. In conclusion, significant genetic differences were evident between carcinomas with PG and NPG patterns. Genetic changes in NPG carcinomas differed from those of the conventional adenoma -carcinoma sequence. Assuming that some nonpolypoid growth lesions transform rapidly into advanced carcinomas, 20% of all colorectal carcinomas may progress in this manner.

show abstract

Section: Discussionmentioning

confidence: 99%

Pathological features and genetic alterations in colorectal carcinomas with characteristics of nonpolypoid growth

Kaneko¹,

Kurahashi²,

Makino³

et al. 2004

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…Estas inovações permitiram também o diagnóstico diferencial endoscópico entre lesões neoplásicas e não-neoplásicas (11,17,18,19,20,21,22) .…”

Section: Introductionunclassified

Colonoscopia com magnificação de imagem: análise da variação interobservadores para os padrões de criptas e comparação das imagens endoscópicas com os achados histopatológicos

Zanoni

Cutait

Averbach

et al. 2006

Rev bras. colo-proctol.

View full text Add to dashboard Cite

RESUMO: A colonoscopia com magnificação de imagem (CMI) é considerada uma técnica que possibilita o diagnóstico diferencial entre lesões colorretais neoplásicas e não-neoplásicas. Este estudo avaliou a variação da concordância interobservadores para os padrões de criptas através de três endoscopistas experientes com a classificação de INTRODUÇÃOO CCR constitui-se em neoplasia frequente no mundo, tendo considerável participação na mortandade por câncer. A prevenção secundária para o CCR é altamente eficaz (1,2) e possibilita a redução considerá-vel em sua mortalidade para os indivíduos submetidos a rastreamento por colonoscopia por permitir a identificação e ressecção dos pólipos colorretais, lesões precursoras do câncer (3) .Contudo, deve-se considerar a possibilidade da não-detecção de lesões polipóides (4,5,6) , a existência de lesões planas diminutas que apresentam comportamento biológico mais agressivo em relação as polipóides do mesmo tamanho (7,8,9,10) ou, então, presença de carcinomas precoces plano-deprimidos que podem ser invasivos, mesmo quando muito pequenos (11,12).Com o advento dos videoendoscópicos de alta resolução, lesões planas e plano-deprimidas, consideradas um desafio ao diagnóstico por colonoscopia convencional, passaram a ser mais frequentemente detectadas (13,14,15,16) e melhor definidas com o emprego da cromoendoscopia (CE) e colonoscopia com magnificação de imagem (CMI). Estas inovações permitiram também o diagnóstico diferencial endoscópico entre lesões neoplásicas e não-neoplásicas (11,17,18,19,20,21,22) .O estabelecimento do diagnóstico histológico de uma lesão ainda durante a endoscopia poderia eco-

show abstract

“…These lesions are thought to be de novo carcinomas because they have no adenomatous component. [4][5][6] The K-ras mutation has been detected much less often in flat or depressed colorectal tumours compared with exophytic tumours. 7,8 Recently, we reported that the RASSF1A gene, which regulates ras function, is frequently hypermethylated in flat or depressed tumours, 9 but this hypermethylation is only infrequently found in conventional colorectal cancers.…”

Section: Introductionmentioning

confidence: 99%