Agreement in interpreting villous elements and dysplasia in adenomas less than one centimetre in size

Lasisi, Femi; Mouchli, Anas; Riddell, Robert H.; Goldblum, John R.; Cummings, Oscar W.; Ulbright, Thomas M.; Rex, Douglas K.

doi:10.1016/j.dld.2013.05.014

Cited by 31 publications

(32 citation statements)

References 18 publications

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“…Further the fraction of polyps ≤ 5 mm and 6-9 mm in size was comparable to or higher than prior studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][22][23][24][25][26][27][28][29] . Any underestimation of polyp size would tend to cause the apparent prevalence of cancer in polyps of different size ranges to increase.…”

supporting

confidence: 78%

“…However, we have demonstrated that interpretation of villous elements and dysplasia grade in small polyps is subject to extreme interobserver variation and poor agreement even among experts 29 . These features have caused the British Society of Gastroenterology to ignore villous elements and dysplasia grade in their post polypectomy surveillance guideline 30 .…”

mentioning

confidence: 85%

“…These features have caused the British Society of Gastroenterology to ignore villous elements and dysplasia grade in their post polypectomy surveillance guideline 30 . We previously reported that experts in gastrointestinal pathology do not use the same definitions of high-grade dysplasia 29 . Specifically, pathologists who utilize cytologic criteria for high-grade dysplasia report much higher prevalence rates of high-grade dysplasia compared to those who use only morphologic criteria 29 .…”

mentioning

confidence: 99%

“…We previously reported that experts in gastrointestinal pathology do not use the same definitions of high-grade dysplasia 29 . Specifically, pathologists who utilize cytologic criteria for high-grade dysplasia report much higher prevalence rates of high-grade dysplasia compared to those who use only morphologic criteria 29 . At the direction of the gastrointestinal pathologists in our unit, our 7 pathologists utilize only morphologic criteria for high-grade dysplasia, which undoubtedly contributes to the low prevalence of high-grade dysplasia in our study.…”

mentioning

confidence: 99%

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Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

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120

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The prevalence of cancer in small and diminutive polyps is relevant to "resect and discard" and CT colonography reporting recommendations.We evaluated a prospectively collected colonoscopy polyp database to identify polyps < 10 mm and those with cancer or advanced histology (high-grade dysplasia or villous elements)Of 32,790 colonoscopies, 15,558 colonoscopies detected 42,630 polyps < 10 mm in size. A total of 4,790 lesions were excluded as they were not conventional adenomas or serrated class lesions.There were 23,524 conventional adenomas < 10 mm of which 22,952 were tubular adenomas.There were 14,316 serrated class lesions of which 13,589 were hyperplastic polyps and the remainder were sessile serrated polyps. Of all conventional adenomas, 96 had high-grade dysplasia including 0.3% of adenomas ≤ 5 mm in size and 0.8% of adenomas 6-9 mm in size. Of all conventional adenomas, 2.1% of those ≤ 5 mm in size and 5.6% of those 6-9 mm in size were advanced. Among 36,107 polyps ≤ 5 mm in size and 6,523 polyps 6-9 mm in size, there were no cancers.These results support the safety of resect and discard as well as current CT colonography reporting recommendations for small and diminutive polyps.

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supporting

confidence: 78%

mentioning

confidence: 85%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Risk of cancer in small and diminutive colorectal polyps

Ponugoti

Cummings

Rex

2017

Digestive and Liver Disease

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120

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“…Pathologists in both academic and community centers are reasonably accurate and consistent at placement of colorectal lesions into these 2 categories 1 . Subcategories of histology, including tubular versus villous and high grade versus low-grade dysplasia within the conventional adenomas 2 , and hyperplastic polyp versus sessile serrated polyp within the serrated class 3 , are subject to considerable interobserver variation in pathologist interpretation.…”

Section: Introductionmentioning

confidence: 99%