Flat and depressed colorectal tumours in a southern Swedish population: a prospective chromoendoscopic and histopathological study
Open Access
- 1 October 2002
- Vol. 51 (4), 550-555
- https://doi.org/10.1136/gut.51.4.550
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.Keywords
This publication has 33 references indexed in Scilit:
- Problems arising from Eastern and Western classification systems for gastrointestinal dysplasia and carcinoma: are they resolvable?Histopathology, 1998
- Flat Adenoma: Are Western Colonoscopists Careful Enough?Endoscopy, 1998
- Flat neoplastic lesions of the colon and rectum detected by high-resolution video endoscopy and chromoscopyGastrointestinal Endoscopy, 1995
- Small flat adenomas appear to have little clinical importance in Western countriesGastrointestinal Endoscopy, 1995
- Flat adenomas and cancersGastrointestinal Endoscopy, 1995
- Minute flat depressed neoplastic lesions of the colon detected by contrast chromoscopy using an indigo carmine capsuleGastrointestinal Endoscopy, 1995
- Depressed Type of Colorectal CancerEndoscopy, 1995
- The discrepancy of histologic diagnosis between flat early colon cancers and flat adenomasGastrointestinal Endoscopy, 1994
- Endoscopic Mucosal Resection of Flat and Depressed Types of Early Colorectal CancerEndoscopy, 1993
- Small “flat adenoma” of the large bowel with special reference to its clinicopathologic featuresDiseases of the Colon & Rectum, 1985