Universität zu Köln

Schramm, Christoph, Kaiser, Moritz, Drebber, Uta, Gruenewald, Inga, Franklin, Jeremy ORCID: 0000-0003-1536-0925, Kuetting, Fabian, Bowe, Andrea, Hoffmann, Vera, Gatzke, Sebastian, Toex, Ulrich and Steffen, Hans-Michael (2016). Factors associated with reclassification of hyperplastic polyps after pathological reassessment from screening and surveillance colonoscopies. Int. J. Colorectal Dis., 31 (2). S. 319 - 326. NEW YORK: SPRINGER. ISSN 1432-1262

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Abstract

A substantial interobserver variation in the differential diagnosis of hyperplastic polyps (HPs) and sessile or traditional serrated adenomas (SSAs/TSAs) has been described. The aim of this study is to determine the magnitude of reclassification of HPs and associated factors after pathological reassessment of specimens from screening and surveillance colonoscopies, and to estimate its consequences for follow-up recommendations. Among 1694 screening and surveillance colonoscopies, a total of 536 polyps were initially diagnosed as HPs and remained unchanged in 88.5 % (n = 474), whereas 7.6 (n = 41) and 1.1 % (n = 6) were reclassified as SSA and TSA, respectively. Compared to definite HPs, SSAs were found more frequently in men than in women (82.9 vs. 61.2 %, p < 0.05), and in individuals a parts per thousand yen65.0 years (51.2 vs. 31.6 %, p = 0.05). Also, more SSAs were > 5 mm in size (36.6 vs. 6.3 %, p < 0.05) and were localized in the proximal colon (31.7 vs. 11.8 %, p < 0.05). In a mixed model analysis, age a parts per thousand yen65.0 years (OR 4.13, 95 % CI 1.22-14.2), snare polypectomy (OR 23.6, 95 % CI 4.86-115), and coincident advanced adenomas (OR 7.56, 95 % CI 1.31-43.5) were significantly (p < 0.05) associated with reclassification to SSAs. Only 0.53 % of patients had received false recommendations for follow-up visits based on the incorrect HP diagnosis. A c.1799T > A, p.V600E BRAF mutation was detected in 21.9 % (n = 9) of reclassified SSAs. Considering these factors may be helpful in serrated lesions that are difficult to allocate. Incorrect recommendations regarding control colonoscopy intervals due to misdiagnosed HPs can explain only a small fraction of interval colorectal cancers.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaiser, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Drebber, Uta UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruenewald, Inga UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED orcid.org/0000-0003-1536-0925 UNSPECIFIED Kuetting, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bowe, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Vera UNSPECIFIED UNSPECIFIED UNSPECIFIED Gatzke, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Toex, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-285730
DOI:	10.1007/s00384-015-2404-6
Journal or Publication Title:	Int. J. Colorectal Dis.
Volume:	31
Number:	2
Page Range:	S. 319 - 326
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1262
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SESSILE SERRATED ADENOMAS; SOCIETY-TASK-FORCE; COLORECTAL-CANCER; PREVALENCE; RISK; POPULATION; POLYPECTOMY; NEOPLASIA; CARCINOMA Multiple languages Gastroenterology & Hepatology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28573