Serrated polyps of the colon and rectum: a concise review

Monreal-Robles, Roberto; Jáquez-Quintana, Joel Omar; Benavides-Salgado, D.E.; González-González, J.A.

doi:10.1016/j.rgmxen.2021.06.001

Cited by 7 publications

(6 citation statements)

References 91 publications

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“…20 The role of SSLs and serrated polyposis in colorectal neoplasia has been appreciated relatively recently and certainly postdates the study by Atkin et al 19,20 Our guidelines combine definitions of HRLs by Atkin et al with high-risk serrated lesions into a set of criteria that, when found on FS, would mandate follow-up colonoscopy (Table 1). 21 Good et al 22 tested these guidelines in a small study in which 29 patients had a colonoscopy after their FS. Only 1 patient younger than 60 years had a high-risk lesion at colonoscopy and that patient also had an HRL at FS.…”

Section: Discussionmentioning

confidence: 99%

Assessing Guidelines on the Need for Colonoscopy after Initial Flexible Sigmoidoscopy in Young Patients with Outlet-Type Rectal Bleeding

Bagshaw,

Tuck,

Aramowicz

et al. 2023

Diseases of the Colon &Amp; Rectum

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BACKGROUND: While young age of onset colorectal cancer is increasing in incidence lack of screening leads to symptomatic presentation, often with rectal bleeding. Because most cancers in patients under 50 are left-sided, flexible sigmoidoscopy is a reasonable way of investigating bleeding in these patients. OBJECTIVE: To predict which patients undergoing flexible sigmoidoscopy for outlet rectal bleeding need a full colonoscopy. DESIGN: Findings at colonoscopy were compared with published indications for colonoscopy after flexible sigmoidoscopy. These were: (1) Any number of advanced adenomas defined as a tubular adenoma >9 mm, a tubulovillous or villous adenoma of any size, or any adenoma with high grade dysplasia. (2) Three or more tubular adenomas of any size or histology. (3) Any sessile serrated lesion. (4) Twenty or more hyperplastic polyps. SETTING: Charity Hospital with volunteer specialists. PATIENTS: Under age 57, outlet type rectal bleeding, undergoing flexible sigmoidoscopy at least to the descending colon, followed by colonoscopy with biopsy of all resected lesions. INTERVENTIONS: Flexible sigmoidoscopy and colonoscopy with excision of all removable lesions. MAIN OUTCOME MEASURES: Findings at colonoscopy. RESULTS: 66 cases who had a colonoscopy between 5 and 811 days after sigmoidoscopy, who also had complete data. Forty-three male and 23 female with mean age of 39.5 years. Analysis of flexible sigmoidoscopy criteria for finding proximal high-risk lesions on colonoscopy showed a sensitivity of 76.9%, a specificity of 67.9%, a positive predictive value of 37%, a negative predictive value of 92.3%, and an accuracy of 69.7%. LIMITATIONS: Large number of exclusions for inadequate colonoscopy or inadequate data causing reduced patient number in the study. CONCLUSION: Our criteria for follow-up colonoscopy based on the findings at initial flexible sigmoidoscopy in young patients with outlet rectal bleeding are reliable enough to be used in routine clinical practice, provided this is audited.

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Section: Discussionmentioning

confidence: 99%

Assessing Guidelines on the Need for Colonoscopy after Initial Flexible Sigmoidoscopy in Young Patients with Outlet-Type Rectal Bleeding

Bagshaw,

Tuck,

Aramowicz

et al. 2023

Diseases of the Colon &Amp; Rectum

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“…When using NBI, these pits manifest as superficial or protruding lesions, occasionally exhibiting a pedunculated morphology ( Figure 4C ). Typically, these lesions exceed 5 mm in size and display dilated vessels, characterized by an expanded and brown capillary network resembling leaf vein, predominantly located in the extensive stromal region surrounding the crypts ( 13 , 42 , 43 ).…”

Section: Serrated Polypsmentioning

confidence: 99%

The histologic features, molecular features, detection and management of serrated polyps: a review

Wang,

Xu,

et al. 2024

Front. Oncol.

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The serrated pathway to colorectal cancers (CRCs) is a significant pathway encompassing five distinct types of lesions, namely hyperplastic polyps (HPs), sessile serrated lesions (SSLs), sessile serrated lesions with dysplasia (SSL-Ds), traditional serrated adenomas (TSAs), and serrated adenoma unclassified. In contrast to the conventional adenoma–carcinoma pathway, the serrated pathway primarily involves two mechanisms: BRAF/KRAS mutations and CpG island methylator phenotype (CIMP). HPs are the most prevalent non-malignant lesions, while SSLs play a crucial role as precursors to CRCs, On the other hand, traditional serrated adenomas (TSAs) are the least frequently encountered subtype, also serving as precursors to CRCs. It is crucial to differentiate these lesions based on their unique morphological characteristics observed in histology and colonoscopy, as the identification and management of these serrated lesions significantly impact colorectal cancer screening programs. The management of these lesions necessitates the crucial steps of removing premalignant lesions and implementing regular surveillance. This article provides a comprehensive summary of the epidemiology, histologic features, molecular features, and detection methods for various serrated polyps, along with recommendations for their management and surveillance.

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“…Colorectal polyp is a common condition of the digestive tract, generally characterized by the absence of any specific clinical manifestations, but it can cause frequent bowel movements, urgency to defecate, blood in stool, abdominal pain, and other clinical symptoms ( Monreal-Robles et al, 2021 ; Lane and Dolejs, 2022 ). It can be divided into many pathological types, including adenomatous, inflammatory, proliferative, hamartoma, and lipoma, of which adenomatous polyps are the most common ( Mareth et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Salivary and fecal microbiota: potential new biomarkers for early screening of colorectal polyps

Zhang,

Feng,

et al. 2023

Front. Microbiol.

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ObjectiveGut microbiota plays an important role in colorectal cancer (CRC) pathogenesis through microbes and their metabolites, while oral pathogens are the major components of CRC-associated microbes. Multiple studies have identified gut and fecal microbiome-derived biomarkers for precursors lesions of CRC detection. However, few studies have used salivary samples to predict colorectal polyps. Therefore, in order to find new noninvasive colorectal polyp biomarkers, we searched into the differences in fecal and salivary microbiota between patients with colorectal polyps and healthy controls.MethodsIn this case–control study, we collected salivary and fecal samples from 33 patients with colorectal polyps (CP) and 22 healthy controls (HC) between May 2021 and November 2022. All samples were sequenced using full-length 16S rRNA sequencing and compared with the Nucleotide Sequence Database. The salivary and fecal microbiota signature of colorectal polyps was established by alpha and beta diversity, Linear discriminant analysis Effect Size (LEfSe) and random forest model analysis. In addition, the possibility of microbiota in identifying colorectal polyps was assessed by Receiver Operating Characteristic Curve (ROC).ResultsIn comparison to the HC group, the CP group’s microbial diversity increased in saliva and decreased in feces (p < 0.05), but there was no significantly difference in microbiota richness (p > 0.05). The principal coordinate analysis revealed significant differences in β-diversity of salivary and fecal microbiota between the CP and HC groups. Moreover, LEfSe analysis at the species level identified Porphyromonas gingivalis, Fusobacterium nucleatum, Leptotrichia wadei, Prevotella intermedia, and Megasphaera micronuciformis as the major contributors to the salivary microbiota, and Ruminococcus gnavus, Bacteroides ovatus, Parabacteroides distasonis, Citrobacter freundii, and Clostridium symbiosum to the fecal microbiota of patients with polyps. Salivary and fecal bacterial biomarkers showed Area Under ROC Curve of 0.8167 and 0.8051, respectively, which determined the potential of diagnostic markers in distinguishing patients with colorectal polyps from controls, and it increased to 0.8217 when salivary and fecal biomarkers were combined.ConclusionThe composition and diversity of the salivary and fecal microbiota were significantly different in colorectal polyp patients compared to healthy controls, with an increased abundance of harmful bacteria and a decreased abundance of beneficial bacteria. A promising non-invasive tool for the detection of colorectal polyps can be provided by potential biomarkers based on the microbiota of the saliva and feces.

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Serrated polyps of the colon and rectum: a concise review

Cited by 7 publications

References 91 publications

Assessing Guidelines on the Need for Colonoscopy after Initial Flexible Sigmoidoscopy in Young Patients with Outlet-Type Rectal Bleeding

Assessing Guidelines on the Need for Colonoscopy after Initial Flexible Sigmoidoscopy in Young Patients with Outlet-Type Rectal Bleeding

The histologic features, molecular features, detection and management of serrated polyps: a review

Salivary and fecal microbiota: potential new biomarkers for early screening of colorectal polyps

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