Saturday abstractSa1428 The Endoscopic Differentiation Features of Sessile Serrated Adenoma/ Polyps With Cytological Dysplasia by NBI Observation
Introduction
We have already reported about the endoscopic features using image enhanced endoscopy (IEE) concerning about sessile serrated leisons. According to WHO classification, sessile serrated lesions are divided into three categories. One is hyperplastic polyps, the other is traditional serrated adenomas and another is sessile serrated adenoma/ polyps (SSA/Ps). However, SSA/Ps are divided into two subtypes with or without cytological dysplasia in accordance with the dysplastic changes. Therefore, it is confused whether SSA/Ps have dysplastic changes or not, because of the usage the word “adenoma” in SSA/P. In this study, we clarified the endoscopic features by NBI observation about the findings of SSA/Ps involved high grade dysplastic changes including submucosal (SM) invasive cancers.
Section snippets
Patients and Methods
Seventy-three SSA/Ps, which are diagnosed according to the WHO criteria were examined before the treatment. These lesions were checked and made by stereoscopy after the resection and diagnosed by two pathologists who are specialized in gastrointestinal tract with using immunohistochemical staining. In this study, CF: H260AZI or FH260AZI scope with Lucera Elite System were used (Olympus Medical Science Tokyo, Japan).
Results
Seventy three lesions enrolled as SSA/P and examined in this study. And also eight lesions were contained typical high grade dysplasia (12.3%). Especially, 4 lesions (6.2%) were invaded into SM layer in among 8 lesions. The mean size of SSA/Ps without cytological dysplasia was 18.1mm. In contrast, that of SSA/Ps with cytological dysplasia was 21.0mm. By the conventional observation, mucus cap is adhered with the surface on entire polyps in all 73 lesions of SSA/Ps except for cytological
Discussion
It concluded that it is possible to differentiate between SSA/P lesion with and without cytological dysplasia by using NBI before the treatment. And also the findings in SM cancers was clarified the invasive portion by magnifying observation. Therefore, it is recommended to use the observation by NBI magnification for SSA/P with cytological dysplasia, especially SM invasion in addition to conventional observation.