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Polyp Size (polyp + size)

Distribution by Scientific Domains

Medical Sciences	85%

Selected Abstracts

Endoscopists' estimation of size should not determine surveillance of colonic polyps

COLORECTAL DISEASE, Issue 7 2010
S. J. Moug
Abstract Objective, Current British Society of Gastroenterology guidelines use adenomatous polyp size as one of the key factors in determining polyp follow-up. This study aimed to compare polyp size assessment by colonoscopists and pathologists before and after fixation to determine the optimal method for measurement. Method, Thirty-five colorectal polyps were found during pre-arranged colonoscopies in one centre. Polyp size was measured to the nearest 1 mm by three different methods: 1by the endoscopist at colonoscopy; 2by the pathologist fresh, following removal; 3by the pathologist fixed, following fixation. The endoscopist and the pathologist were blinded to each other's measurements. Results, Seventeen men, eighteen women with mean age of 66.2 years (SD: 9.4, range: 38.7,85.5) underwent polypectomy/s with all polyps removed intact. Polypectomies were performed by consultants (43%), nurse specialists (34%) and specialist registrars (23%). The median size (mm) of polyps measured were endoscopically, 6.5 (2,25 mm); fresh specimen 7.0 (4,28 mm) and fixed 7.0 (4,28 mm). Endoscopic measurements were significantly lower than that of fresh and fixed sizes (P < 0.001 and P = 0.003 respectively), with poor correlation [correlation of variance (CV): 21.0% and intraclass correlation coefficient (ICCC): 0.841 for endoscopic and fresh measurements; CV: 21.1% and ICCC: 0.838 for endoscopic and fixed measurements]. There was no statistical difference between fresh and fixed specimen measurements (P > 0.05; CV: 4.2%, ICCC: 0.974). In three patients, the endoscopic measurement was < 1 cm in polyps that were found to be , 1 cm on pathological measurement. Conclusions, Endoscopists consistently underestimated polyp size. Fixation had no effect on polyp size. Pathologists' measurement of polyp size on fixed specimens should determine the need for further colonoscopic follow-up. [source]

Nutritional physiology and colony form in Podocoryna carnea (Cnidaria: Hydrozoa)

INVERTEBRATE BIOLOGY, Issue 4 2008
Dirk Bumann
Abstract. We compared growth rates and final morphological states of the athecate colonial hydroid Podocoryna carnea in two nutritional environments: one varying the quantity of food provided at a fixed interval and the second varying the time between feedings of a fixed quantity. In both environments, replicate colonies were either fed uniformly, or fed on only one side and starved on the other. In addition, we fed colonies fluorescence-labeled cultures of Artemia salina and documented the subsequent distribution of label. We found that both the growth rates and the final morphological state varied logarithmically with food supply. Heterogeneous feeding had a marked effect on colony morphology, with a sharp boundary in polyp number, stolon density, and polyp size forming at the fed,unfed interface. The distribution of fluorescence was correlated with sites of colony growth. These results confirm and extend early work on the priority of growth zones in colonial hydroids, and present new challenges for understanding the relationship among energy metabolism, gastrovascular circulation, and colony form. [source]

Comparison of malignant potential between serrated adenomas and traditional adenomas

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2007
Sang Yong Song
Abstract Background:, Serrated adenoma is a discrete colorectal epithelial neoplastic lesion that can evolve into colorectal cancer. However, the degree of malignant potential has not been firmly established as yet. The purpose of the present paper was to compare the malignant potential and clinicopathological features between serrated and traditional adenomas. Methods:, A total of 124 serrated adenomas from 116 patients were assessed, and 419 traditional adenomas from 200 were randomly selected. The combination of nuclear dysplasia and serration of ,20% of crypts was regarded as serrated adenoma. The clinicopathological features of serrated and traditional adenomas were compared, and multivariate analysis performed to confirm whether the malignant potential of serrated adenoma was similar to that of traditional adenoma. Results:, The differences in age, sex, total number of adenomas, and synchronous lesions including adenoma with high-grade dysplasia and carcinoma between subjects with and without serrated adenoma were not significant. Serrated adenomas were more frequently located in the rectum and sigmoid colon (P < 0.001), and the average size of serrated adenomas was greater than that of traditional adenomas (P < 0.05). The incidence of malignant lesions including high-grade dysplasia and carcinoma in serrated adenomas was found to be lower than in traditional adenomas (3.2% vs 9.3%, P < 0.05). In the multivariate analysis, adenoma type and polyp size constituted the risk factors for the incidence of high-grade dysplasia and carcinoma. Conclusions:, Serrated adenoma is a premalignant lesion, but it has a lower potential for the development of malignancy than traditional adenomas. [source]

Poor correlation between clinical impression, the small colonic polyp and their neoplastic risk

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2006
Ian Craig Lawrance
Abstract Background and Objectives:, ,Significance of the small colonic polyp is unclear and its removal is frequently determined by the proceduralist's clinical impression. Our aims were to determine if clinical discernment is accurate, and the likelihood that lesions <,10 mm are histologically advanced. Method:, ,We prospectively collected 1988 lesions from 854 subjects (2215 consecutive colonoscopies). Lesion size, location, patient age, sex and the colonoscopist's clinical impression was recorded. Results:, Clinical assessment for neoplasia had a sensitivity of 87.4%, specificity of 65.0%, positive predictive value of 76.0% and negative predictive value of 80.2%, resulting in an accuracy of 73.4%. Factors predictive of correct clinical impression were polyp size, location in the rectum and being pedunculated, but not the patient's age, sex or the endoscopist's experience. Of the 1434 lesions ,,5 mm in size, 44.5% were neoplastic and 3.5% were histologically advanced. Of the 266 lesions 6,9 mm, 79.3% were neoplastic, 19.9% were histologically advanced, five demonstrated high-grade dysplasia and three were malignant. Only two patients with an adenocarcinoma or high-grade dysplasia in a polyp <10 mm had a lesion ,10 mm elsewhere in the colon. Of the 288 lesions ,10 mm in size, 92.7% were neoplastic, 29.5% had a villous component, 6.9% demonstrated high-grade dysplasia and 29.2% were malignant. Factors predictive of neoplasia were patient age, polyp size and sessile nature of the lesion. Conclusion:, Polyps <,10 mm had a significant risk of neoplasia and advanced histology and, in general, clinical impression correlated poorly with neoplasia. Removal of all lesions proximal to the rectum, regardless of size, should therefore be considered. [source]

Systematic review: distribution of advanced neoplasia according to polyp size at screening colonoscopy

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
C. HASSAN
Summary Background, The impact of not referring sub-centimetre polyps identified at CT colonography upon the efficacy of colorectal cancer screening remains uncertain. Aim, To determine the distribution of advanced neoplasia according to polyp size in a screening setting. Methods, Published studies reporting the distribution of advanced adenomas in asymptomatic screening cohorts according to polyp size were identified by MEDLINE and EMBASE searches. Predefined outputs were the screening rates of advanced adenomas represented by diminutive (,5 mm), small (6,9 mm), sub-centimetre (<10 mm) and large (,10 mm) polyp sizes. Results, Data from four studies with 20 562 screening subjects met the primary inclusion criteria. Advanced adenomas were detected in 1155 (5.6%) subjects (95% CI = 5.3,5.9), corresponding to diminutive, small and large polyps in 4.6% (95% CI = 3.4,5.8), 7.9% (95% CI = 6.3,9.4) and 87.5% (95% CI = 86,89.4) of cases respectively. The frequency of advanced lesions among patients whose largest polyp was diminutive, small, sub-centimetre and large in size was 0.9%, 4.9%, 1.7% and 73.5% respectively. Conclusions, Based on this systematic review, a 6-mm polyp size threshold for polypectomy referral would identify over 95% of subjects with advanced adenomas, whereas a 10-mm threshold would identify 88% of cases. Aliment Pharmacol Ther,31, 210,217 [source]