Endoscopic characteristics to differentiate SSLs and microvesicular hyperplastic polyps from goblet cell-rich...

Area of Science:

• Gastroenterology
• Endoscopic Imaging
• Colorectal Cancer Prevention

Background:

• Colorectal serrated polyps (SPs) encompass sessile serrated lesions (SSLs) and hyperplastic polyps (HPs).
• Endoscopic differentiation between SSLs, microvesicular HPs (MVHPs), and goblet cell-rich HPs (GCHPs) remains challenging due to similar appearances.
• Understanding subtle endoscopic distinctions is crucial for accurate diagnosis and management of SPs.

Purpose of the Study:

• To compare the endoscopic features of SSLs, MVHPs, and GCHPs.
• To identify endoscopic findings that can reliably distinguish between these subtypes of serrated polyps.
• To enhance the accuracy of endoscopic diagnosis for colorectal serrated polyps.

Main Methods:

• Retrospective, cross-sectional study analyzing 670 serrated polyps (SPs).
• Evaluation of endoscopic features including polyp size, location, Paris classification, mucus cap, border, crypt opening, microvasculature, and JNET classification.
• Multivariable logistic regression analysis to determine predictors of SP histology.

Main Results:

• Sessile serrated lesions (SSLs) and microvesicular hyperplastic polyps (MVHPs) exhibited more mucus caps, expanded crypt openings, and varicose microvascular vessels compared to goblet cell-rich hyperplastic polyps (GCHPs).
• SSLs were generally larger and more proximal in the colon than MVHPs.
• No significant differences were found in other assessed endoscopic features between the groups.

Conclusions:

• Endoscopic features differentiate SSLs and MVHPs from GCHPs.
• Recognizing MVHPs and GCHPs as distinct entities can improve endoscopic diagnosis of serrated polyps.
• This study provides valuable insights for endoscopists in distinguishing between colorectal serrated polyp subtypes.