Abstract
Background: Flat and depressed colorectal tumours are common in Japan but are very rare or non-existent in Western countries.
Aims: To study the occurrence of flat colorectal tumours in a southern Swedish population.
Methods: In this prospective study, 371 consecutive European patients were examined by high resolution video colonoscopy combined with chromoendoscopy. The nature of the lesions was determined by histopathological examination.
Results: A total of 973 tumours were found; 907 (93.2%) were protruding and 66 (6.8%) were flat or depressed. Of the flat/depressed tumours, five (7.7%) were early adenocarcinomas infiltrating the submucosa. Eleven carcinomas (1.2%) were found among protruding tumours. High grade dysplasia was observed in 18% (n=11) of flat/depressed adenomas in contrast with 7.3% (n=65) of protruding adenomas, and occurred in smaller flat/depressed tumours compared with protruding ones (mean diameter 8 mm v 23 mm, respectively). Furthermore, high grade dysplasia was significantly more common in flat elevated tumours with central depression or in depressed adenomas (35.7%; 5/14) than in flat elevated adenomas (12.8%; 6/47).
Conclusion: Flat and depressed tumours exist in a Western population. Future studies should address whether or not chromoendoscopy with video colonoscopy is necessary in the search for flat colorectal neoplasms.
Aims: To study the occurrence of flat colorectal tumours in a southern Swedish population.
Methods: In this prospective study, 371 consecutive European patients were examined by high resolution video colonoscopy combined with chromoendoscopy. The nature of the lesions was determined by histopathological examination.
Results: A total of 973 tumours were found; 907 (93.2%) were protruding and 66 (6.8%) were flat or depressed. Of the flat/depressed tumours, five (7.7%) were early adenocarcinomas infiltrating the submucosa. Eleven carcinomas (1.2%) were found among protruding tumours. High grade dysplasia was observed in 18% (n=11) of flat/depressed adenomas in contrast with 7.3% (n=65) of protruding adenomas, and occurred in smaller flat/depressed tumours compared with protruding ones (mean diameter 8 mm v 23 mm, respectively). Furthermore, high grade dysplasia was significantly more common in flat elevated tumours with central depression or in depressed adenomas (35.7%; 5/14) than in flat elevated adenomas (12.8%; 6/47).
Conclusion: Flat and depressed tumours exist in a Western population. Future studies should address whether or not chromoendoscopy with video colonoscopy is necessary in the search for flat colorectal neoplasms.
Original language | English |
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Pages (from-to) | 550-555 |
Journal | Gut |
Volume | 51 |
Issue number | 4 |
DOIs | |
Publication status | Published - 2002 |
Subject classification (UKÄ)
- Gastroenterology and Hepatology
Free keywords
- Prospective Studies
- Middle Age
- Male
- Human
- Sweden: epidemiology
- Support
- Non-U.S. Gov't
- Endoscopy
- Adenoma: epidemiology
- Adenoma: pathology
- Adult
- Aged
- Colorectal Neoplasms: pathology
- Carcinoma: pathology
- Colorectal Neoplasms: epidemiology
- Gastrointestinal: methods
- Female
- 80 and over
- Carcinoma: epidemiology