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Clinicopathologic features of the flat adenoma
1Second Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Diseases of the Colon and Rectum
|November 1, 1991
Summary
Small flat adenomas (SFAs) show a higher malignancy rate than ordinary polyps, especially in females. These adenomas are linked to patient history and family cancer history, supporting the adenoma-carcinoma sequence.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Small flat adenomas (SFAs) are a distinct histological subtype of colorectal adenomas.
- Understanding the clinicopathologic features of SFAs is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the clinicopathologic features of small flat adenomas (SFAs).
- To assess the malignancy rate and associated risk factors for SFAs.
Main Methods:
- Retrospective analysis of 128 SFAs from 101 patients.
- Evaluation of clinicopathologic features, including atypia, patient history, family history, and size.
- Comparison of malignancy rates with ordinary small polypoid adenomas.
Main Results:
- SFAs were more common in males (3.4:1 ratio).
- Malignancy rate was higher in females (31.8%) vs. males (9.3%).
- History of colorectal neoplasms (65%) and cancer families (21/37) were associated with SFAs.
- Malignancy rate increased with size, with an overall rate of 13.3% (vs. 2.8% for ordinary adenomas).
- SFAs were more proximal but site did not correlate with malignancy.
- Central depression was noted in 20 lesions, more frequent with higher atypia.
- Severe atypia often included a component of lower atypia, supporting the adenoma-carcinoma sequence.
Conclusions:
- SFAs exhibit a significantly higher malignancy potential compared to ordinary small polypoid adenomas.
- Risk factors for SFAs include male gender, family history of cancer, and personal history of colorectal neoplasms.
- The findings support the adenoma-carcinoma sequence in the development of SFAs.