Document Detail

Comparison of the clinicopathologic features between flat and polypoid adenoma.
MedLine Citation:
PMID:  18609172     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Several reports have suggested that flat colorectal adenomas might exhibit a higher potential for malignancy compared to polypoid adenomas. Although the clinical importance of the shape of polyps is stressed, the controversy surrounding the malignant potential of flat adenomas continues. The aim of this study was to compare the clinicopathologic characteristics, including degree of dysplasia and malignancy, between flat and polypoid adenomas 5 mm in size or larger. MATERIAL AND METHODS: A total of 3263 polyps (254 flat adenomas and 3009 polypoid adenomas), >/=5 mm in size, diagnosed in 1883 patients by colonoscopy were analyzed. RESULTS: Flat adenomas were found in 10% of patients, which represented 7.8% of all adenomas removed. The flat adenomas were larger in diameter than the polypoid adenomas (14.8+/-12.6 mm versus 8.6+/-5.0 mm, p <0.01), had a higher rate of villous components (18.5% versus 11.4%, p <0.01), a higher rate of high-grade dysplasia (9.4% versus 4.2%, p <0.01), and a higher rate of malignancy (10.2% versus 3.6%, p <0.01) than polypoid adenomas. However, there was no difference in the rate of high-grade dysplasia or carcinoma between flat and polypoid adenomas of equal size. It was shown by multivariate analysis that rectosigmoid location, larger size, and presence of a villous component were associated with a higher rate of malignancy, but not with flat morphology. CONCLUSIONS: Flat adenomas, which were of a relatively large size in this study, were not associated with a higher risk for high-grade dysplasia and carcinoma compared with polypoid adenomas.
Sang Kil Lee; Tae Il Kim; Sung Kwan Shin; Won Ho Kim; Hoguen Kim; Nam Kyu Kim
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  43     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-19     Completed Date:  2008-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  1116-21     Citation Subset:  IM    
Departments of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Adenoma / pathology*
Adenomatous Polyps / pathology*
Analysis of Variance
Biopsy, Needle
Cohort Studies
Colonic Polyps / pathology*
Colonoscopy / methods
Colorectal Neoplasms / pathology*
Diagnosis, Differential
Intestinal Mucosa / pathology
Logistic Models
Middle Aged
Multivariate Analysis
Precancerous Conditions / pathology*
Retrospective Studies
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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