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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(11): E1251-E1259
DOI: 10.1055/a-2301-6463
Original article

Endoscopic characteristics to differentiate SSLs and microvesicular hyperplastic polyps from goblet cell-rich hyperplastic polyps

Osamu Toyoshima 
1   Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku, Tokyo, Japan (Ringgold ID: RIN577428)
,
Toshihiro Nishizawa
1   Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku, Tokyo, Japan (Ringgold ID: RIN577428)
2   Department of Gastroenterology and Hepatology, International University of Health and Welfare Narita Hospital, Narita, Japan (Ringgold ID: RIN625200)
,
Hidenobu Watanabe
3   Pathology and Cytology Laboratory Japan, Tokyo, Japan
,
Tatsuya Matsuno
1   Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku, Tokyo, Japan (Ringgold ID: RIN577428)
,
Shuntaro Yoshida
1   Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku, Tokyo, Japan (Ringgold ID: RIN577428)
,
Yoshiyuki Takahashi
1   Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku, Tokyo, Japan (Ringgold ID: RIN577428)
,
Hiroya Mizutani
1   Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku, Tokyo, Japan (Ringgold ID: RIN577428)
4   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hirotoshi Ebinuma
2   Department of Gastroenterology and Hepatology, International University of Health and Welfare Narita Hospital, Narita, Japan (Ringgold ID: RIN625200)
,
Mitsuhiro Fujishiro 
4   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yutaka Saito
5   Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
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Abstract

Background and study aims Among colorectal serrated polyps (SPs), sessile serrated lesions (SSLs) and hyperplastic polyps (HPs) have a similar endoscopic appearance. However, the endoscopic distinctions between those two categories, microvesicular HPs (MVHPs) and goblet cell-rich HPs (GCHPs), are not well understood. Therefore, we compared the endoscopic features of SSLs, MVHPs, and GCHPs.

Methods This retrospective, cross-sectional study was conducted at the Toyoshima Endoscopy Clinic. We examined polyp size, location, Paris classification type, mucus cap, indistinct border, expanded crypt opening, varicose microvascular vessels, and JNET classification type. Multivariable analysis of each endoscopic finding using a binomial logistic regression model determined the factors that predicted SP histology.

Results A total of 670 SPs were enrolled in this study, comprising 159 SSLs, 361 MVHPs, and 150 GCHPs. On comparing the SSL + MVHP group and the GCHP group, a mucus cap (partial regression coefficient 1.705), expanded crypt opening (1.828), and varicose microvascular vessels (1.270) were more often observed in the SSL + MVHP group compared with the GCHP group. In the comparison between MVHPs and GCHPs, a mucus cap (1.564), expanded crypt opening (1.802), and varicose microvascular vessels (1.288) were more often found in MVHPs in contrast to GCHPs. When comparing SSLs and MVHPs, SSLs were more likely to be in the proximal colon (0.662) and were larger (0.198) than the MVHPs. No significant differences were observed in other endoscopic findings.

Conclusions SSLs and MVHPs have endoscopic appearances that differ from those of GCHPs. Considering MVHPs and GCHPs as distinct entities may aid in endoscopic diagnosis of SPs.

Keywords

Endoscopy Lower GI Tract - Polyps / adenomas / ... - Tissue diagnosis - GI Pathology


Publication History

Received: 06 November 2023

Accepted after revision: 02 April 2024

Accepted Manuscript online:
08 April 2024

Article published online:
07 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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