TITLE

ANATOMICAL CLUSTERING OF TYPE II FLAT AND DEPRESSED COLORECTAL LESIONS: RELATIONSHIP BETWEEN DYSPLASIA, NEOPLASIA, AND MORPHOLOGY SUBTYPE

AUTHOR(S)
Hurlstone, D.P.; Shorthouse, A.J.; Adam, I.; Brown, S.; Cross, S.S.; Korulla, C.; Davies, D.; Lobo, A.J.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA21
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: Current data suggest that more than 30% of all adenomatous colorectal lesions are of Flat morphology (Japanese Research Society Classification type II - JRSC). Reporting of anatomical preponderance has however been inconsistent in Western cohorts. Malignant potential in this group is significant. The optimal approach to diagnosis, management and eventual screening in the UK will be influenced by anatomical distribution. Aim: To evaluate the anatomical distribution of JRSC type II colorectal lesions in the UK and establish if any association exists between site and dysplastic/neoplastic transformation. Subjects and Methods: Total colonoscopy was performed on 600 consecutive patients, by a single endoscopist using the Olympus CF240Z endoscope from 01/02 to 09/02.0.5% indigo carmine was used to facilitate detection. Anatomical site was recorded for each lesion identified. Morphology was documented using the JRSC system. Histological analysis was obtained on all specimens by cold biopsy, endoscopic mucosal resection or en-block resection. Results: See Table. For lesions with sd or beyond, 78% were located in the right colon, 14.6% left, and 6.5% rectum. 32/41 (92.6%) of lesions with sd or beyond had a depressed component morphologically. Conclusions: Flat lesions with areas of depression are associated with sd and show a right-hemi-colonic preponderance. Total colonoscopy is required for adequate detection of these lesions (95% would not be detected using flexible sigmoidoscopy alone).
ACCESSION #
9747400

 

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