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Endoscopic Diagnosis of Serrated Adenoma Using Magnifying Endoscopy Hisatomo Ikehara 1 , Yutaka Saito 1 , Chika Kusano 1 , Takahisa Matsuda 1 1Endoscopy Division, National Cancer Center Hospital, Tokyo Keyword: serrated adenoma , 大腸腺腫 , 過形成性ポリープ , 大腸癌 pp.307-311
Published Date 2007/3/25
DOI https://doi.org/10.11477/mf.1403100968
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 Serrated adenoma (SA) is a distinct form of adenoma. It is characterized by a serrated epithelium resembling a metaplastic polyp. A total of 12,302 lesions were removed endoscopically at this clinic from January, 1999 to December, 2005. The present study shows the endoscopic findings in 95 colorectal serrated adenomas detected in 79 patients. Among these lesions, 56 (58.9%) lesions were located in the sigmoid colon and rectum. Eighty-one lesions (85.3%) were protruded type, 14 (14.7%) were superficial type. The mean size of SAs was 13.3 mm (range 3~45 mm). Thirty-nine SAs (41.1%) were between 6 to 10 mm in diameter. Nine (9.5%) of all SAs had the component of intramucosal carcinoma. This suggests that SA should be removed endoscopically in the same manner as tubular adenomas.

 Magnifying endoscopic assessment was obtained in 93 SAs (97.9 %). The diagnostic accuracy for IVH pit pattern for serrated adenomas by magnifying colonoscopy was 50.0%. The accuracy for IIIH pit pattern with IVH or IV pit pattern was 38.1 %. The diagnostic accuracy for IIIH pit pattern was not satisfactory (26.8 %). In the present study, the accuracy rate of the IVH pit pattern was high, so we suggest that the IVH pit pattern is useful for differentiating serrated adenomas by magnifying colonoscopy, especially in the protruded SAs. Although an endoscopic pit pattern classification for the diagnosis of serrated adenoma has not been established, magnifying endoscopy is expected to become a key diagnostic method for discrimination between serrated adenoma and other polyps.


Copyright © 2007, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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