Pathogenesis and Management of Serrated Polyps: Current Status and Future Directions

Anderson, Joseph C.

doi:10.5009/gnl14248

Cited by 29 publications

(30 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our goal was to use data from the New Hampshire Colonoscopy Registry (NHCR) to compare the ADR in screening colonoscopies conducted in obese adults and smokers to those in individuals without these risk factors. Given the association between the serrated pathway and a large proportion of CRC 14 as well as interest in using the detection of serrated polyps as a potential quality measure for colonoscopy 15,16 , we also examined the serrated polyp detection rates (SDR) in these risk groups.…”

Section: Introductionmentioning

confidence: 99%

Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults

Anderson

Weiss

Robinson³

et al. 2017

Journal of Clinical Gastroenterology

Self Cite

View full text Add to dashboard Cite

Goal To examine screening adenoma detection rates (ADR) and serrated detection rates (SDR) among smokers and obese adults in the New Hampshire Colonoscopy Registry. Background ADR, a quality measure for screening colonoscopies, is associated with protection from interval colorectal cancer (CRC). Currently, only sex-specific ADR benchmarks are reported. However, obesity and smoking ≥ 20 pack-years are strong predictors for colorectal neoplasia, as highlighted by the 2009 American College of Gastroenterology CRC Screening Guidelines. Data comparing ADR in smokers and obese adults to those without these risks are limited. Study We calculated ADR, SDR and 95% confidence intervals for screening colonoscopies in participants ≥ 50 years. Sex and sex-age specific rates were compared by smoking exposure (never versus < 20 pack-years versus ≥ 20 pack-years) and body mass index (BMI < 30 versus BMI ≥ 30). Results 21,539 screening colonoscopies were performed by 77 endoscopists at 20 facilities (4/2009 -9/2013). The difference in ADR between non-smokers and smokers with ≥ 20 pack-years was 8.8% (p < 0.0001) and between obesity groups 5.0% (p<0.0001). Significant sex specific and sex-age specific increases in ADR and SDR were found among smokers and obese participants. Conclusions ADR and SDR for smokers and obese adults were significantly higher than their counterparts without those risks. Endoscopists should consider the prevalence of these risks within their screening population when comparing their rates to established benchmarks. Calculating sex or sex-age specific ADR and SDR based on smoking and obesity may provide optimal protection for populations with a particularly high prevalence of smokers and obese adults.

show abstract

Section: Introductionmentioning

confidence: 99%

Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults

Anderson

Weiss

Robinson³

et al. 2017

Journal of Clinical Gastroenterology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Activating mutations of the RAS-RAF-MAPK pathway have been reported to initiate and sustain lesions in the serrated pathway, and the presence of a positive CpG island methylation phenotype and DNA repair genes might play a major role in colorectal neoplastic progression[5,38,39]. Compared with serrated polyps of the colon, extracolonic serrated polyps are virtually undescribed and their genetic alterations are largely unknown.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients

Cao

Dong

et al. 2016

WJG

View full text Add to dashboard Cite

AIMTo analyse the clinical features of patients with the serrated lesions in the upper gastrointestinal tract (UPGI) tract.METHODSPatients who underwent routine esophagogastroduodenoscopy (EGD) at the Digestive Endoscopy Centre of General Hospital, Tianjin Medical University between January 2011 and December 2015 were consecutively recruited. Patients with UPGI serrated lesions were consecutively identified. The patients’ demographics and histopathology were recorded. The colorectal findings for patients who underwent colonoscopy simultaneously or within six months were also extracted from the colonoscopy database. In addition, we analysed differences in colorectal neoplasia detection between the study patients and randomly selected patients matched for age and gender who did not exhibit serrated lesions and who also underwent colonoscopy in the same period.RESULTSA total of 21 patients out of 98746 patients (0.02%) who underwent EGD were confirmed to have serrated lesions with predominantly crenated, sawtooth-like configurations. The mean age of the 21 patients was (55.3 ± 17.2) years, and 11 patients were male (52.4%). In terms of the locations of the serrated lesions, 17 were found in the stomach (including 3 in the cardia, 9 in the corpus and 5 in the antrum), 3 were found in the duodenum, and 1 was found in the esophagus. Serrated lesions were found in different mucosal lesions, with 14 lesions were detected in polyps (8 hyperplastic polyps and 6 serrated adenomas with low grade dysplasia), 3 detected in Ménétrier gastropathy, 3 detected in an area of inflammation or ulcer, and 1 detected in the intramucosal carcinoma of the duodenum. In addition, colonoscopy data were available for 18 patients, and a significantly higher colorectal adenoma detection rate was observed in the UPGI serrated lesions group than in the randomly selected age- and gender-matched group without serrated lesions who also underwent colonoscopy in the same period (38.9% vs 11.1%, OR = 5.091, 95%CI: 1.534-16.890, P = 0.010). The detection rate of advanced adenoma was also higher in the UPGI serrated lesions group (22.2% vs 4.2%, OR = 6.571, 95%CI: 1.322-32.660, P = 0.028).CONCLUSIONSerrated lesions in the UPGI were detected in various mucosal lesions with different pathological morphologies. Moreover colonoscopy is recommended for the detection of concurrent colorectal adenoma for these patients.

show abstract

“…They tend to be flat in the proximal colon (75%), 64% being bigger than 5mm, and 17% bigger than 10mm. The proximal hyperplastic polyps with more than 5mm could be classified as serrated 8 , while most non-serrated or adenomatous lesions would occur in the left colon 14 . Authors state that the proximal hyperplastic polyps, greater than 10mm may be considered sessile serrated adenomas.…”

Section: Discussionmentioning

confidence: 99%

“…Even so, they are now considered important, representing 7.5% to 30% of all colorectal carcinomas according to several authors 8 .…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of endoscopic and histopathological features of superficial elevated lesions resected by endoscopic mucosal resection in the distal and proximal colon

Parada

Ribas

Venco³

et al. 2016

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

Objective: to compare endoscopic and histopathologic features of superficial, elevated lesions with one or more centimeters in diameter, diagnosed by videocolonoscopy on the distal and proximal colon, and subjected to mucosal resection. Methods: we conducted a retrospective, cross-sectional, observational study involving 8,075 videocolonoscopies. From this total, we evaluated 166 mucosectomies in 145 patients with superficial, elevated lesions with a diameter equal to or greater than 1cm. Results: the lesion prevalence was lower in G1 than in G2 (34.9% vs. 65%). The mean age, gender distribution and size (1.9cm in G1 versus 2.0cm in G2, p=0.921) were similar. There was no difference of mucosal surfaces in relation to the location (p=0.575). Considering Intraepithelial neoplasias, both the low grade, high grade (including carcinomas) and hyperplasic ones showedd no difference (p=0.527), nor did the neoplastic lesions when divided into serrated and non-serrated (p=0.124). Excluding 13 hyperplastic lesions and two carcinomas, 124 (82.1%) were non-serrated and 27 (17.9%), serrated. Conclusion: were found no significant differences between endoscopic and histopathological aspects of superficial, elevated lesions of 1cm or more in diameter in distal colon compared with the proximal, when resected by mucosectomy. Although not significant, there was a tendency of association between the location of the lesion and the presence of serrated features.

show abstract

Pathogenesis and Management of Serrated Polyps: Current Status and Future Directions

Cited by 29 publications

References 51 publications

Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults

Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults

Clinical features of upper gastrointestinal serrated lesions: An endoscopy database analysis of 98746 patients

Comparative analysis of endoscopic and histopathological features of superficial elevated lesions resected by endoscopic mucosal resection in the distal and proximal colon

Contact Info

Product

Resources

About