摘要
AIM:To elucidate the colonoscopic features of serrated lesions of the colorectum using magnifying colonoscopy.METHODS:Broad division of serrated lesions of the colorectum into hyperplastic polyps(HPs),traditional serrated adenomas(TSAs),and sessile serrated adenomas/polyps(SSA/Ps) has been proposed on the basis of recent molecular biological studies.However,few reports have examined the colonoscopic features of these divisions,including magnified colonoscopic findings.This study examined 118 lesions excised in our hospital as suspected serrated lesions after magnified observation between January 2008 and September 2011.Patient characteristics(sex,age),conventional colonoscopic findings(location,size,morphology,color,mucin) and magnified colonoscopic findings(pit pattern diagnosis) were interpreted by five colonoscopists with experience in over 1000 colonoscopies,and were compared with histopathological diagnoses.The pit patterns were categorized according to Kudo's classification,but a more detailed investigation was also performed using the subclassification [type Ⅱ-Open(type Ⅱ-O),type Ⅱ-Long(type Ⅱ-L),or type Ⅳ-Serrated(type Ⅳ-S)] proposed by Kimura T and Yamano H.RESULTS:Lesions comprised 23 HPs(23/118:19.5%),39 TSAs(39/118:33.1%:with cancer in one case),50 SSA/Ps(50/118:42.4%:complicated with cancer in three cases),and six others(6/118:5.1%).We excluded six others,including three regular adenomas,one hamartoma,one inflammatory polyp,and one juvenile polyp for further analysis.Conventional colonoscopy showed that SSA/Ps were characterized as larger in diameter than TSAs and HPs(SSA/P vs HP,13.62 ± 8.62 mm vs 7.74 ± 3.24 mm,P < 0.001;SSA/Ps vs TSA,13.62 ± 8.62 mm vs 9.89 ± 5.73 mm,P < 0.01);common in the right side of the colon [HPs,30.4%(7/23):TSAs,20.5%(8/39):SSA/P,84.0%(42/50),P < 0.001];flat-elevated lesion [HPs,30.4%(7/23):TSAs,5.1%(2/39):SSA/Ps,90.0%(45/50),P < 0.001];normal-colored or pale imucosa [HPs,34.8%(8/23):TSAs,10.3%(4/39):SSA/Ps,80%(40/50),P < 0.001];and with large amounts of muc
AIM：To elucidate the colonoscopic features of serrated lesions of the colorectum using magnifying colonoscopy.METHODS：Broad division of serrated lesions of the colorectum into hyperplastic polyps（HPs）,traditional serrated adenomas（TSAs）,and sessile serrated adenomas/polyps（SSA/Ps） has been proposed on the basis of recent molecular biological studies.However,few reports have examined the colonoscopic features of these divisions,including magnified colonoscopic findings.This study examined 118 lesions excised in our hospital as suspected serrated lesions after magnified observation between January 2008 and September 2011.Patient characteristics（sex,age）,conventional colonoscopic findings（location,size,morphology,color,mucin） and magnified colonoscopic findings（pit pattern diagnosis） were interpreted by five colonoscopists with experience in over 1000 colonoscopies,and were compared with histopathological diagnoses.The pit patterns were categorized according to Kudo＇s classification,but a more detailed investigation was also performed using the subclassification [type Ⅱ-Open（type Ⅱ-O）,type Ⅱ-Long（type Ⅱ-L）,or type Ⅳ-Serrated（type Ⅳ-S）] proposed by Kimura T and Yamano H.RESULTS：Lesions comprised 23 HPs（23/118：19.5%）,39 TSAs（39/118：33.1%：with cancer in one case）,50 SSA/Ps（50/118：42.4%：complicated with cancer in three cases）,and six others（6/118：5.1%）.We excluded six others,including three regular adenomas,one hamartoma,one inflammatory polyp,and one juvenile polyp for further analysis.Conventional colonoscopy showed that SSA/Ps were characterized as larger in diameter than TSAs and HPs（SSA/P vs HP,13.62 ± 8.62 mm vs 7.74 ± 3.24 mm,P 〈 0.001;SSA/Ps vs TSA,13.62 ± 8.62 mm vs 9.89 ± 5.73 mm,P 〈 0.01）;common in the right side of the colon [HPs,30.4%（7/23）：TSAs,20.5%（8/39）：SSA/P,84.0%（42/50）,P 〈 0.001];flat-elevated lesion [HPs,30.4%（7/23）：TSAs,5.1%（2/39）：SSA/Ps,90.0%（45/50）,P 〈 0.001];normal-
基金
Supported by The Japanese Foundation for Research and Promotion of Endoscopy (JFE),in part
The Japanese Society of Gastroenterology (JSGE),to Watanabe Y
The Princess Takamatsu Cancer Research Fund
A Generous Gift from both the JFE and the JSGE
