Abstract
Current colonoscopy techniques, including high definition white light endoscopy, pit pattern analysis by chromoendoscopy, and equipment-based image-enhanced endoscopy such as narrow band imaging enable accurate real-time histological diagnosis of colorectal lesions. Most premalignant polyps, including adenomas and sessile serrated adenoma/polyps, should be resected endoscopically. Piecemeal resection may be a good option for large benign adenomas. Early colorectal cancers, such as mucosal and superficial submucosal cancers without histological features associated with poor prognosis, can be managed by endoscopic resection. En bloc resection of early colorectal cancers can minimize the risk of recurrence and achieve accurate histopathological evaluation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Abbreviations
- CI:
-
Confidence interval
- CIMP:
-
CpG island methylation phenotype
- CIN:
-
Chromosomal instability
- CRC:
-
Colorectal cancer
- EMR:
-
Endoscopic mucosal resection
- EPMR:
-
Endoscopic piecemeal mucosal resection
- ESD:
-
Endoscopic submucosal dissection
- HP:
-
Hyperplastic polyp
- LST:
-
Laterally spreading tumor
- LST-G:
-
Granular laterally spreading tumor
- LST-NG:
-
Nongranular laterally spreading tumor
- MMR:
-
Mismatch repair
- MSI:
-
Microsatellite instability
- NBI:
-
Narrow band imaging
- NICE:
-
NBI International Colorectal Endoscopic
- SSA/P:
-
Sessile serrated adenoma/polyp
- TSA:
-
Traditional serrated adenoma
- WASP:
-
Workgroup serrAted polypS & Polyposis
References
IJspeert JE, Medema JP, Dekker E. Colorectal neoplasia pathways: state of the art. Gastrointest Endosc Clin N Am. 2015;25(2):169–82.
Pino MS, Chung DC. The chromosomal instability pathway in colon cancer. Gastroenterology. 2010;138(6):2059–72.
Bosman FT, Carneiro F, Hruban R. World Health Organization classification of tumours of the digestive system. Lyon, France: IARC Press; 2010.
Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy. 2005;37(6):570–8.
Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 1996;44(1):8–14.
Hewett DG, Kaltenbach T, Sano Y, Tanaka S, Saunders BP, Ponchon T, Soetikno R, Rex DK. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology. 2012;143(3):599–607.
Technology Committee ASGE, Abu Dayyeh BK, Thosani N, Konda V, Wallace MB, Rex DK, Chauhan SS, Hwang JH, Komanduri S, Manfredi M, Maple JT, Murad FM, Siddiqui UD, Banerjee S. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc. 2015;81(3):502–16.
IJspeert JE, Bastiaansen BA, van Leerdam ME, Meijer GA, van Eeden S, Sanduleanu S, Schoon EJ, Bisseling TM, Spaander MC, van Lelyveld N, Bargeman M, Wang J, Dekker E; Dutch Workgroup serrAted polypS & Polyposis (WASP). Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps. Gut. 2016;65(6):963–70.
Bond JH. Polyp guideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol. 2000;95(11):3053–63.
Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, Hamaguchi T, Hyodo I, Igarashi M, Ishida H, Ishiguro M, Kanemitsu Y, Kokudo N, Muro K, Ochiai A, Oguchi M, Ohkura Y, Saito Y, Sakai Y, Ueno H, Yoshino T, Fujimori T, Koinuma N, Morita T, Nishimura G, Sakata Y, Takahashi K, Takiuchi H, Tsuruta O, Yamaguchi T, Yoshida M, Yamaguchi N, Kotake K, Sugihara K. Japanese Society for Cancer of the Colon and Rectum. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol. 2012;17(1):1–29.
Rex DK, Ahnen DJ, Baron JA, Batts KP, Burke CA, Burt RW, Goldblum JR, Guillem JG, Kahi CJ, Kalady MF, O'Brien MJ, Odze RD, Ogino S, Parry S, Snover DC, Torlakovic EE, Wise PE, Young J, Church J. Serrated lesions of the colorectum: review and recommendations from an expert panel. Am J Gastroenterol. 2012;107(9):1315–29.
Kudo Se, Lambert R, Allen JI, Fujii H, Fujii T, Kashida H, Matsuda T, Mori M, Saito H, Shimoda T, Tanaka S, Watanabe H, Sung JJ, Feld AD, Inadomi JM, O'Brien MJ, Lieberman DA, Ransohoff DF, Soetikno RM, Triadafilopoulos G, Zauber A, Teixeira CR, Rey JF, Jaramillo E, Rubio CA, Van Gossum A, Jung M, Vieth M, Jass JR, Hurlstone PD. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc. 2008;68(4 Suppl):S3–47.
Uraoka T, Saito Y, Matsuda T, Ikehara H, Gotoda T, Saito D, Fujii T. Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum. Gut. 2006;55(11):1592–7.
Kim JS, Lee BI, Choi H, Jun SY, Park ES, Park JM, Lee IS, Kim BW, Kim SW, Choi MG. Cold snare polypectomy versus cold forceps polypectomy for diminutive and small colorectal polyps: a randomized controlled trial. Gastrointest Endosc. 2015;81(3):741–7.
Moss A, Williams SJ, Hourigan LF, Brown G, Tam W, Singh R, Zanati S, Burgess NG, Sonson R, Byth K, Bourke MJ. Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut. 2015;64(1):57–65.
Bae JH, Yang DH, Lee S, Soh JS, Lee S, Lee HS, Lee HJ, Park SH, Kim KJ, Ye BD, Myung SJ, Yang SK, Byeon JS. Optimized hybrid endoscopic submucosal dissection for colorectal tumors: a randomized controlled trial. Gastrointest Endosc. 2016;83(3):584–92.
Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. United States Multi-Society Task Force on Colorectal Cancer. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143(3):844–57.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Byeon, JS. (2017). How to Recognize, Characterize, and Manage Premalignant and Malignant Colorectal Polyps. In: Lee, S., Ross, H., Rivadeneira, D., Steele, S., Feingold, D. (eds) Advanced Colonoscopy and Endoluminal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-48370-2_12
Download citation
DOI: https://doi.org/10.1007/978-3-319-48370-2_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-48368-9
Online ISBN: 978-3-319-48370-2
eBook Packages: MedicineMedicine (R0)