Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK

Rembacken, Björn; Fujii, Takeshi; Cairns, Alison; Dixon, M. F.; Yoshida, Shigeaki; Chalmers, D M; Axon, A. T. R.

doi:10.1016/s0140-6736(00)02086-9

Cited by 607 publications

(358 citation statements)

References 23 publications

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“…Flat adenomas, which may have a higher risk to contain dysplastic tissue [22], are well known to be difficult to detect with CT colonography. Several investigators have suggested that detection of such lesions should preferably be done with 2D review methods [23].…”

Section: Discussionmentioning

confidence: 99%

A comparison of primary two- and three-dimensional methods to review CT colonography

et al. 2006

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The aim of our study was to compare primary three-dimensional (3D) and primary two-dimensional (2D) review methods for CT colonography with regard to polyp detection and perceptive errors. CT colonography studies of 77 patients were read twice by three reviewers, first with a primary 3D method and then with a primary 2D method. Mean numbers of true and false positives, patient sensitivity and specificity and perceptive errors were calculated with colonoscopy as a reference standard. A perceptive error was made if a polyp was not detected by all reviewers. Mean sensitivity for large (≥10 mm) polyps for primary 3D and 2D review was 81% (14.7/18) and 70% (12.7/18), respectively (p-values ≥0.25). Mean numbers of large false positives for primary 3D and 2D were 8.3 and 5.3, respectively. With primary 3D and 2D review 1 and 6 perceptive errors, respectively, were made in 18 large polyps (p=0.06). For mediumsized (6-9 mm) polyps these values were for primary 3D and 2D, respectively: mean sensitivity: 67%(11.3/17) and 61%(10.3/17; p-values≥ 0.45), number of false positives: 33.3 and 15.6, and perceptive errors : 4 and 6 (p= 0.53). No significant differences were found in the detection of large and medium-sized polyps between primary 3D and 2D review.

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Section: Discussionmentioning

confidence: 99%

A comparison of primary two- and three-dimensional methods to review CT colonography

et al. 2006

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“…'de novo' carcinogenesis (Shamsuddin et al, 1985;Shimoda et al, 1989;Rembacken et al, 2000). A fair number of the colonic carcinomas are assumed to arise directly from colonic mucosa unlike exadenoma.…”

Section: Discussionmentioning

confidence: 99%

Frequent p53 mutation in brain (fetal)-type glycogen phosphorylase positive foci adjacent to human ‘de novo’ colorectal carcinomas

et al. 2001

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‘de novo’ carcinogenesis has been advocated besides ‘adenoma carcinoma sequence’ as another dominant pathway leading to colorectal carcinoma. Our recent study has demonstrated that the distribution of brain (fetal)-type glycogen phosphorylase (BGP) positive foci (BGP foci) has a close relationship with the location of ‘de novo’ carcinoma. The aims of the present study are to investigate genetic alteration in the BGP foci and to characterize them in the ‘de novo’ carcinogenesis. 17 colorectal carcinomas without any adenoma component expressing both immunoreactive p53 and BGP protein were selected from 96 resected specimens from our previous study. Further investigations to examine the proliferating cell nuclear antigen (PCNA)-labelling index, and the p53 and the codon 12 of K-ras mutation using the polymerase chain reaction-single strand conformation polymorphism were performed in the BGP foci, BGP negative mucosa and carcinoma. The BGP foci were observed sporadically in the transitional mucosa adjacent to the carcinoma in all cases. The PCNA labelling index in the BGP foci was significantly higher than that in the BGP negative mucosa ( P < 0.001). p53 mutations were observed in 8 carcinomas, but no K-ras mutation was detected. Interestingly, although none of the overexpressions of p53 protein was detected immunohistochemically in the BGP positive foci, the p53 gene frequently (41.2% of the BGP foci tested) mutated in spite of no K-ras mutation. The present study demonstrates potentially premalignant foci in the colorectal transitional mucosa with frequent p53 gene mutation. It is suggested that BGP foci are promising candidates for the further investigation of ‘de novo’ colorectal carcinogenesis. © 2001Cancer Research Campaign http://www.bjcancer.com

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“…The identification of superficial small invasive cancers without an adenomatous component has introduced the concept of colorectal cancer coming ''de novo'' [10] and studies also suggested that flat lesions could be more aggressive than non-flat adenomas [11][12][13].…”

Section: Flat Lesionsmentioning

confidence: 99%

“…Rembacken et al [13] showed that lesions smaller than 1 cm in size, both flat and non-flat, rarely had neoplastic focuses.…”

Section: Flat Lesionsmentioning

confidence: 99%

Flat lesions missed at conventional colonoscopy (CC) and visualized by CT colonography (CTC): a pictorial essay

Coppola

Regge²,

Flor

et al. 2013

Abdom Imaging

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The purpose of this study is to describe our experience with cases of false negative findings at conventional colonoscopy (CC) that were identified by CT colonography (CTC). Conventional colonoscopy (CC) is the universally accepted gold-standard technique for the diagnosis of colonic polyps and cancers, however occasionally this method can generate false negative findings. We present examples of false negatives at CC, correctly identified by CT colonography (CTC), and later confirmed at a second endoscopy, describing the reasons of false negative, when possible.CT colonography is a highly sensitive technique for polyps and colorectal cancer (CRC) detection [1] across a broad spectrum of accepted indications and protocols (preparation, fecal tagging, CO 2 automatic insufflation, hypotonization). Its sensitivity is high especially for detecting polyps greater than 10 mm; however, CTC is less accurate than CC for small and diminutive polyps [1][2][3][4].However, when CC is performed by inexperienced operators and non-gastroenterologists or when lesions have atypical morphologies disappointing low sensitivities may occasionally be reported [5]. The commonalities of typical lesions missed at CC usually concern their location and shape: false negative results can be generated when incomplete colonoscopies are performed (cecum not reached), when lesions are hidden behind haustral folds or when they are flat or present atypical morphologies. On the other side, typical lesions missed at CTC are usually located in the rectosigmoid colon and in the splenic flexure, due to a minor effect of the insufflation in this segments [1]. Right colon is usually easier to distend and consequently evaluate at CTC, while the increased distance in CC makes right colon assessment more difficult. For the above reported reasons CT colonography and CC should be considered equivalent in terms of sensitivity in CRC detection and complementary [1].

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Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK

Cited by 607 publications

References 23 publications

A comparison of primary two- and three-dimensional methods to review CT colonography

A comparison of primary two- and three-dimensional methods to review CT colonography

Frequent p53 mutation in brain (fetal)-type glycogen phosphorylase positive foci adjacent to human ‘de novo’ colorectal carcinomas

Flat lesions missed at conventional colonoscopy (CC) and visualized by CT colonography (CTC): a pictorial essay

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