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Finding Sessile Serrated Adenomas: Is It Possible to Identify Them During Conventional Colonoscopy?
MedLine Citation:
PMID:  25073956     Owner:  NLM     Status:  Publisher    
BACKGROUND AND AIM: Proximal colorectal cancer may arise from sessile serrated adenomas (SSAs). Recognition of these lesions during colonoscopy can optimize the endoscopic approach. We aimed to identify specific endoscopic features of SSA with conventional colonoscopy.
METHODS: Patients undergoing screening colonoscopies from January 2011 to September 2012, in whom colonic polyps were found, were prospectively included in our study. Polyp morphology, location, polyp pit pattern (Kudo classification), and other previously reported features of SSA were evaluated. Histological examination was conducted independently by two pathologists. Multivariate analysis was performed to identify independent predictors of SSA.
RESULTS: A total of 272 patients were included, and 440 polyps were evaluated (1.6 polyps per patient). Thirty-four polyps (8 %) were SSA, 135 (31 %) hyperplastic, and 249 (56 %) adenomas. The most prevalent endoscopic features of SSA were right-side location (94 %), type II Kudo pit pattern (91 %), mucus cap (41 %), flat morphology (29 %) and red-colored surface (26 %). Multivariate analysis revealed that flat morphology (p = 0.002, OR = 3.81 CI 1.53-9.09), red-colored surface (p < 0.001, OR = 12.97 CI 4.43-37.69), right-side location (p < 0.001, OR = 22.21 CI 5.09-135.94) and mucus cap (p < 0.001, OR 8.77 CI 3.76-20.44) were independent predictors of SSA.
CONCLUSION: We were able to identify specific features of SSA during conventional colonoscopy, which may help to identify, and therefore to optimize the endoscopic approach of these lesions.
Lisandro Pereyra; Estanislao J Gómez; Raquel González; Carolina Fischer; Gastón Babot Eraña; Alfredo G Torres; Leandro Correa; José M Mella; Guillermo N Panigadi; Pablo Luna; Silvia C Pedreira; Daniel G Cimmino; Luis A Boerr
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-30
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  -     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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