Intestinal Research

Original Articles

Colorectal neoplasia

A survey of current practices in post-polypectomy surveillance in Korea: Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, on behalf of the Intestinal Tumor Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2024;22(2):186-207. Published online April 25, 2024; DOI: https://doi.org/10.5217/ir.2023.00109

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists.
Methods
In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed.
Results
In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years.
Conclusions
A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

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Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma: Eun Ju Chung, Ji Young Lee, Jaewon Choe, Hye-Sook Chang, Jongcheol Kim, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Kyung-Jo Kim, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung; Intest Res 2015;13(4):318-325. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.318

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

Chicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM.

Methods

This cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed.

Results

The prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., ≥2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM.

Conclusions

CSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.

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Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps
Ying-Jie Zhang, Meng-Xia Yuan, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2024; 16(3): 750. CrossRef
White spots around colorectal tumors are cancer-related findings and may aid endoscopic diagnosis: a prospective study in Japan
Kai Korekawa, Yusuke Shimoyama, Fumiyoshi Fujishima, Hiroshi Nagai, Takeo Naito, Rintaro Moroi, Hisashi Shiga, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
Clinical Endoscopy.2024; 57(5): 637. CrossRef
Solitary juvenile polyp of the rectum with intramucosal adenocarcinoma
Kazuki Nagai, Uichiro Fuchizaki, Yoshimichi Ueda
Clinical Journal of Gastroenterology.2023; 16(4): 532. CrossRef
Chicken skin mucosa surrounding small colorectal cancer could be an endoscopic predictive marker of submucosal invasion
Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2023; 15(6): 1062. CrossRef
Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China
Jie Dong, Tian-Shi Ma, Yuan-Hong Xu, Peng Li, Wan-Yuan Chen, Jiang-Feng Tu, You-Wei Chen
BMC Gastroenterology.2022;[Epub] CrossRef
Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
Gut and Liver.2022; 16(5): 754. CrossRef
Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
You-Wei Chen, Jiang-Feng Tu, Wen-Juan Shen, Wan-Yuan Chen, Jie Dong
World Journal of Gastroenterology.2020; 26(8): 877. CrossRef
Hepatitis B Virus Infection Is Independently Associated With Advanced Colorectal Adenoma
Su Hwan Kim, Ji Won Kim, Kook Lae Lee, Seohui Lee, Seong-Joon Koh, Ji Bong Jeong, Byeong Gwan Kim
The American Journal of the Medical Sciences.2018; 356(2): 141. CrossRef
Current strategies for malignant pedunculated colorectal polyps
Adriana Ciocalteu, Dan Ionut Gheonea, Adrian Saftoiu, Liliana Streba, Nicoleta Alice Dragoescu, Tiberiu Stefanita Tenea-Cojan
World Journal of Gastrointestinal Oncology.2018; 10(12): 465. CrossRef

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Recurrence of Colorectal Neoplasm Cannot Be Predicted by Sonic Hedgehog Expression in the Normal Colonic Tissue: Ji Young Lee, Sun-Young Lee, Hye Seung Han, So Young Kim, Sung Noh Hong, Jeong Hwan Kim, In Kyung Sung, Hyung Seok Park, Chan Sup Shim, Choon Jo Jin; Intest Res 2012;10(3):265-271. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.265

Abstract PDF: Background/Aims
The expression of sonic hedgehog (Shh) in the colon cancer cell has been implicated in colorectal carcinogenesis. However, the association between Shh expression in the normal colonic mucosa and the recurrence of colorectal neoplasm after tumor resection has not been well documented. The aim of the study was to determine the association between Shh expression in the normal colonic mucosa and in the recurrence of colorectal neoplasm. Methods: Fifty-five patients who underwent a long-term follow-up colonoscopy after the colorectal neoplasm resection were included. At the time of the tumor resection, Shh expression in the normal colonic mucosa was examined. The association between Shh expression in the normal colonic mucosa and the recurrence of colorectal neoplasm was analyzed. Results: In total, 97 colorectal neoplasms were detected among 41 subjects after a mean follow-up period of 63 weeks (range 27-254 weeks). Of 55 subjects, 26 (47.3%) exhibited positive Shh expression in the normal colonic tissue, and the recurrence rate did not differ with the degree of Shh expression (P=0.238). The degree of Shh expression was not associated with the number (P=0.389), size (P=0.928), location (P=0.410), pathologic types (P=0.127), or time of recurrence (P=0.711) of the recurred colorectal neoplasm. Conclusions: Most colorectal neoplasm patients show recurrence after the resection and exhibit Shh expression in the normal colonic tissue. The degree of Shh expression in the normal colonic mucosa does not predict the recurrence of colorectal neoplasm. (Intest Res 2012;10: 0-271)

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Relationship between Positron Emission Tomography Uptake and Macroscopic Findings of Colorectal Cancer: So Young Kim, Sun-Young Lee, Hwa-Kyung Lim, Ji Young Lee, Sung Noh Hong, Jeong Hwan Kim, In Kyung Sung, Hyung Seok Park, Chan Sup Shim, Choon Jo Jin, Hyun Woo Chung, Young So; Intest Res 2012;10(2):168-175. Published online April 30, 2012; DOI: https://doi.org/10.5217/ir.2012.10.2.168

Abstract PDF

Background/Aims
The semiquantitative parameter "standard uptake value" (SUV) of ¹⁸Fluorodeoxyglucose (FDG) positron-emission tomography (PET) provides important additional information about colorectal cancer. In general, colorectal cancers exhibit different growth patterns with different clinicopathological characteristics. The aim of this study was to elucidate the link between the macroscopic appearance of colorectal cancers and maximum SUV (SUV_max) FDG uptakes. Methods: We analyzed 347 patients with colorectal cancer who underwent PET scanning before treatment. The SUV_max of colorectal cancer was analyzed by examining PET images. The macroscopic appearance of each colorectal cancer was classified into three major types: ulcerofungating (n=223), ulceroinfiltrating (n=44), and fungating (n=78). Two cases that were difficult to classify were excluded from the study. Results: The SUV_max was higher in colorectal cancers with an ulcerofungating appearance (12.19±5.84, mean±standard deviation) and ulceroinfiltrating appearance (11.66±5.63) than in those with a fungating appearance (9.58±6.67; P=0.005) (ulcerofungating and ulceroinfiltrative vs. fungating, P＜0.001). A smaller tumor size (P＜0.001) were significantly related to the fungating colorectal cancer. Four out of six colorectal cancers that did not show FDG uptake were the fungating type. Conclusions: Colorectal cancers with a fungating appearance exhibit a lower SUV_max, shallower invasion and smaller tumor size. Our results indicate that colorectal cancers with a fungating appearance would be less prominent on PET scan than those with an ulcerofungating or ulceroinfiltrating appearance, and thus require more attention. (Intest Res 2012;10: 0-175)

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Diagnostic and prognostic value of preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography
Joo Young Lee, Soon Man Yoon, Jeong Tae Kim, Ki Bae Kim, Mi Jin Kim, Jae Geun Park, Taek-Gu Lee, Sang-Jeon Lee, Sung Soo Koong, Joung-Ho Han, Hee Bok Chae, Seon Mee Park, Sei Jin Youn
Intestinal Research.2017; 15(2): 208. CrossRef
Does Diabetes Mellitus Influence Standardized Uptake Values of Fluorodeoxyglucose Positron Emission Tomography in Colorectal Cancer?
Da Yeon Oh, Ji Won Kim, Seong-Joon Koh, Mingoo Kim, Ji Hoon Park, Su Yeon Cho, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im
Intestinal Research.2014; 12(2): 146. CrossRef

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