Effects of upwelling, depth, morphology and polyp size on feeding in three species of Panamanian corals

The utility of molecular markers for predicting the risk of metachronous advanced colorectal lesions (MACLs) remains poorly investigated. We examined the relationship between somatic hypermethylation in polyps at baseline and the risk of developing MACL. This retrospective cohort study included 281 consecutive patients with colonic polyps who were enrolled between 2007 and 2009 and followed-up until 2014. MACLs were defined as adenomas of >10 mm, high-grade dysplasia, or with a villous component; and serrated lesions of >10 mm or with dysplasia. In total, 595 polyps were removed at baseline colonoscopy and analyzed for pathological characteristics and CpG island methylator phenotype (CIMP) using the MS-MLPA (Methylation-Specific -- Multiplex Ligation-dependent Probe Amplification) technique. Forty-five patients (16.0%) showed at least one CIMP+ polyp. MACL risk was higher in patients with CIMP+ polyps (odds ratio (OR), 4.50; 95% CI, 1.78–11.4; p = 0.002). Patients with CIMP+ polyps also exhibited shorter time to MACL development (33.8 months vs. 50.1 months; p < 0.001), even with adjustment for polyp size and number (OR, 2.40; 95% CI, 1.33–4.34). Adding CIMP analysis improved the sensitivity (57.0% to 70.9%), negative predictive value (71.1% to 77.3%), and overall accuracy (49.8% to 52.0%) for MACL risk estimation. These results highlight that CIMP may be a useful marker for endoscopic surveillance.

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Detectability on Plain CT is an Effective Discriminator between Carcinoma and Benign Disorder for a Polyp >10 mm in the Gallbladder

Diagnostics ◽

10.3390/diagnostics11030388 ◽

2021 ◽

Vol 11 (3) ◽

pp. 388

Author(s):

Tatsunori Satoh ◽

Masataka Kikuyama ◽

Keiko Sasaki ◽

Hirotoshi Ishiwatari ◽

Shinya Kawaguchi ◽

...

Keyword(s):

Computed Tomography ◽

Multivariate Analysis ◽

Odds Ratio ◽

Patient Characteristics ◽

Polyp Size ◽

Predictive Values ◽

Lesion Detectability ◽

Contrast Enhanced ◽

Cell Densities ◽

Sensitivity Specificity

An appropriate diagnosis is required to avoid unnecessary surgery for gallbladder cholesterol polyps (GChPs) and to appropriately treat pedunculated gallbladder carcinomas (GCs). Generally, polyps >10 mm are regarded as surgical candidates. We retrospectively evaluated plain and contrast-enhanced (CE) computed tomography (CT) findings and histopathological features of 11 early GCs and 10 GChPs sized 10–30 mm to differentiate between GC and GChP >10 mm and determine their histopathological background. Patient characteristics, including polyp size, did not significantly differ between groups. All GCs and GChPs were detected on CE-CT; GCs were detected more often than GChPs on plain CT (73% vs 9%; p < 0.01). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for GCs were 73%, 90%, 89%, 75%, and 81%, respectively. On multivariate analysis, lesion detectability on plain CT was independently associated with GCs (odds ratio, 27.1; p = 0.044). Histopathologically, GChPs consisted of adipose tissue. Although larger vessel areas in GCs than in GChPs was not significant (52,737 μm2 vs 31,906 μm2; p = 0.51), cell densities were significantly greater in GCs (0.015/μm2 vs 0.0080/μm2; p < 0.01). Among GPs larger than 10 mm, plain CT could contribute to differentiating GCs from GChPs.

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Protrusion Method for Automated Estimation of Polyp Size on CT Colonography

American Journal of Roentgenology ◽

10.2214/ajr.07.2865 ◽

2008 ◽

Vol 190 (5) ◽

pp. 1279-1285 ◽

Cited By ~ 9

Author(s):

C. van Wijk ◽

J. Florie ◽

C. Y. Nio ◽

E. Dekker ◽

A. H. de Vries ◽

...

Keyword(s):

Ct Colonography ◽

Polyp Size

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An endoscopic training model to improve accuracy of colonic polyp size measurement

International Journal of Colorectal Disease ◽

10.1007/s00384-010-0878-9 ◽

2010 ◽

Vol 25 (5) ◽

pp. 655-660 ◽

Cited By ~ 9

Author(s):

Chi-Yang Chang ◽

Han-Mo Chiu ◽

Hsiu-Po Wang ◽

Ching-Tai Lee ◽

John Jen Tai ◽

...

Keyword(s):

Training Model ◽

Colonic Polyp ◽

Size Measurement ◽

Polyp Size ◽

Endoscopic Training ◽

Improve Accuracy

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A118 POLYP SIZE CUT-OFF LEVEL TO IMPLEMENT OPTICAL POLYP DIAGNOSIS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.116 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 98-99

Author(s):

M Taghiakbari ◽

R Djinbachian ◽

D von Renteln

Keyword(s):

Colorectal Polyps ◽

Optical Diagnosis ◽

Clinical Implementation ◽

Polyp Size ◽

Funding Agencies ◽

Size Groups ◽

Surveillance Interval ◽

High Reduction ◽

Advanced Adenomas ◽

Post Hoc

Abstract Background Optical polyp diagnosis can be used for real-time pathology prediction of colorectal polyps ≤10 mm. However, the risk of misdiagnosing a polyp with advanced pathology potentially increases with increasing polyp size. Aims This study aimed to evaluate different size cut-offs for using optical polyp diagnosis and the associated risk of patients undergoing inadequate follow-up or surveillance. Methods In a post-hoc analysis of two prospective studies, the performance of optical diagnosis was evaluated in three polyp size groups: 1–3 mm, 1–5 mm, and 1–10 mm. The primary outcome was the proportion of patients with advanced adenomas and delayed or inappropriate surveillance. Secondary outcomes included percentage of polyps with advanced pathology, agreement between surveillance intervals based on high-confidence optical diagnosis and pathology outcomes, reduction in histopathological examinations, and proportion of patients who could receive an immediate surveillance interval recommendation. Results We included 1525 patients with complete colonoscopies (mean age 62.9 years, 50.2% male). The percentage of patients with advanced adenomas and delayed or inappropriate surveillance was 0.7%, 1.7%, and 1.8% when using optical diagnosis for patients with polyps of 1–3, 1–5, and 1–10 mm, respectively. The percentage of polyps with advanced pathology was 0.5%, 1.4%, and 1.9%, respectively. Surveillance interval agreement between pathology and optical diagnosis was 99%, 98%, and 97.8%, respectively. Total reduction in pathology examinations was 33.9%, 53.5%, and 69.0%, respectively. Conclusions A 3-mm cut-off for clinical implementation of optical polyp diagnosis yielded high surveillance interval agreement with pathology and a high reduction in pathology examinations while minimizing the risk of inappropriate management for polyps with advanced pathology. Funding Agencies None

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Risk factors for post-polypectomy bleeding; a retrospective case-control study of a high-volume colonoscopy center

Zeitschrift für Gastroenterologie ◽

10.1055/a-1690-7795 ◽

2021 ◽

Author(s):

Dimitrios Eleftheriadis ◽

Christina Imalis ◽

Guido Gerken ◽

Heiner Wedemeyer ◽

Jan Duerig

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Ileocecal Valve ◽

Binary Logistic Regression ◽

High Volume ◽

Binary Logistic Regression Analysis ◽

Care Hospital ◽

Retrospective Case ◽

Polyp Size ◽

Epinephrine Injection

Abstract Background and aim Post-polypectomy bleeding (PPB) remains an uncommon although serious complication of colonoscopy. The aim of this study is to determine the PPB-prevalence in a secondary care hospital and its associated risk factors. Patients and methods We collected data from 581 patients, with the removal of 1593 polyps between August 2017 and August 2019. A univariate binary logistic regression analysis was conducted retrospectively. Results PPB occurred in only 10 cases, representing 1.7% of patients: immediate in 1.2% and delayed in 0.5%. The number of removed polyps per patient [4.5 (SD 2.59) for hemorrhagic vs. 2.74 (SD 1.98) for non-hemorrhagic group] and the propofol dose [232 mg (SD 93.07) for hemorrhagic vs. 133 mg (SD 57.28) for non-hemorrhagic group] were relevant patient-related risk factors. The polyp-based analysis showed the polyp size [18.4 mm (SD 10.44) for hemorrhagic vs. 4.42 mm (SD 4.29) for non-hemorrhagic group], the morphology [wide-based: OR 24.83 (95 % CI 2.76 – 223.44), pedunculated: OR 56.67 (95 % CI 5.03 – 638.29)], the location at ileocecal valve [OR 20.48, 95 % CI 1.81 – 231.97)], and the polypectomy method [hot snare piecemeal with epinephrine injection: OR 75.38 (95 % CI 7.67 – 741.21)] as significant risk factors for PPB, too. Conclusions The low rate of PPB confirms the safety of the procedure in non-tertiary, high-volume colonoscopy centers. The number of polyps removed per patient, the polyp size, morphology and location, as well as the sedation dose and the method of polypectomy were shown as relevant risk factors.

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Influence of patient age and colorectal polyp size on histopathology findings

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000200006 ◽

2014 ◽

Vol 27 (2) ◽

pp. 109-113 ◽

Cited By ~ 7

Author(s):

Silvana Marques e SILVA ◽

Viviane Fernandes ROSA ◽

Antônio Carlos Nóbrega dos SANTOS ◽

Romulo Medeiros de ALMEIDA ◽

Paulo Gonçalves de OLIVEIRA ◽

...

Keyword(s):

Demographic Data ◽

Colorectal Polyp ◽

Proximal Colon ◽

Colorectal Polyps ◽

University Hospital ◽

Consecutive Series ◽

Polyp Size ◽

Patient Age ◽

Cross Sectional ◽

Patient Âgé

BACKGROUND: Colorectal cancer is a major cause of morbidity and mortality and can arise through the adenoma-carcinoma sequence. Colonoscopy is considered the method of choice for population-wide cancer screening. AIM: To assess the characteristics of endoscopically resected polyps in a consecutive series of patients who underwent colonoscopy at a university hospital and compare histopathology findings according to patient age and polyp size. METHODS: Retrospective, cross-sectional of 1950 colonoscopy reports from consecutively examined patients. The sample was restricted to reports that mentioned colorectal polyps. A chart review was carried out for collection of demographic data and histopathology results. Data were compared for polyps sized ≤0.5 cm and ≥0.6 cm and then for polyps sized ≤1.0 cm and ≥1.1 cm. Finally, all polyps resected from patients aged 49 years or younger were compared with those resected from patients aged 50 years or older. RESULTS: A total of 272 colorectal polyps were resected in 224 of the 1950 colonoscopies included in the sample (11.5%). Polyps >1 cm tended to be pedunculated (p=0.000) and were more likely to exhibit an adenomatous component (p=0.001), a villous component (p=0.000), and dysplasia (p=0.003). These findings held true when the size cutoff was set at 0.5 cm. Patients aged 50 years or older were more likely to have sessile polyps (p=0.023) and polyps located in the proximal colon (p=0.009). There were no significant differences between groups in histopathology or presence of dysplasia. CONCLUSION: Polyp size is associated with presence of adenomas, a villous component, and dysplasia, whereas patient age is more frequently associated with sessile polyps in the proximal colon.

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Inaccurate polyp size estimation can affect patient management: endoscopic estimates of polyp size should be abandoned in favor of the pathologist's measurement

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(96)80312-9 ◽

1996 ◽

Vol 43 (4) ◽

pp. 368 ◽

Cited By ~ 1

Author(s):

C Margulies ◽

RE Schoen ◽

LD Gerber ◽

JL Weissfeld

Keyword(s):

Patient Management ◽

Size Estimation ◽

Polyp Size

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Endoscopic resection outcomes and predictors of failed en bloc endoscopic mucosal resection of colorectal polyps ≤ 20 mm among advanced endoscopy trainees

Endoscopy International Open ◽

10.1055/a-1578-1965 ◽

2021 ◽

Vol 09 (11) ◽

pp. E1820-E1826

Author(s):

William W. King ◽

Peter V. Draganov ◽

Andrew Y. Wang ◽

Dushant Uppal ◽

Amir Rumman ◽

...

Keyword(s):

Multivariate Analysis ◽

Endoscopic Mucosal Resection ◽

En Bloc Resection ◽

Lesion Size ◽

Bloc Resection ◽

Colorectal Polyps ◽

Polyp Size ◽

En Bloc ◽

Mucosal Resection ◽

Piecemeal Resection

Abstract Background and study aims En bloc endoscopic mucosal resection (EMR) is preferred over piecemeal resection for polyps ≤ 20 mm. Data on colorectal EMR training are limited. We aimed to evaluate the en bloc EMR rate of polyps ≤ 20 mm among advanced endoscopy trainees and to identify predictors of failed en bloc EMR. Methods This was a multicenter prospective study evaluating trainee performance in EMR during advanced endoscopy fellowship. A logistic regression model was used to identify the number of procedures and lesion cut-off size associated with an en bloc EMR rate of ≥ 80 %. Multivariate analysis was performed to identify predictors of failed en bloc EMR. Results Six trainees from six centers performed 189 colorectal EMRs, of which 104 (55 %) were for polyps ≤ 20 mm. Of these, 57.7 % (60/104) were resected en bloc. Trainees with ≥ 30 EMRs (OR 6.80; 95 % CI: 2.80–16.50; P = 0.00001) and lesions ≤ 17 mm (OR 4.56;95 CI:1.23–16.88; P = 0.02) were more likely to be associated with an en bloc EMR rate of ≥ 80 %. Independent predictors of failed en bloc EMR on multivariate analysis included: larger polyp size (OR:6.83;95 % CI:2.55–18.4; P = 0.0001), right colon location (OR:7.15; 95 % CI:1.31–38.9; P = 0.02), increased procedural difficulty (OR 2.99; 95 % CI:1.13–7.91; P = 0.03), and having performed < 30 EMRs (OR: 4.87; 95 %CI: 1.05–22.61; P = 0.04). Conclusions In this pilot study, we demonstrated that a relatively low proportion of trainees achieved en bloc EMR for polyps ≤ 20 mm and identified procedure volume and lesion size thresholds for successful en bloc EMR and independent predictors for failed en bloc resection. These preliminary results support the need for future efforts to define EMR procedure competence thresholds during training.

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