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CC BY-NC-ND 4.0 · Endosc Int Open
DOI: 10.1055/a-2301-6463
Original article

Endoscopic characteristics to differentiate sessile serrated lesion and microvesicular hyperplastic polyp from goblet cell-rich hyperplastic polyp

Osamu Toyoshima 
1   Gastroenterology, Toyoshima　Endoscopy Clinic, Tokyo, Japan
,
Toshihiro Nishizawa
2   Department of Gastroenterology and Hepatology, International University of Health and Welfare Narita Hospital, Narita, Japan (Ringgold ID: RIN625200)
,
Hidenobu Watanabe
3   Department of Molecular Genetics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
,
Tatsuya Matsuno
4   Gastroenterology, Toyoshima　Endoscopy Clinic, Tokyo, Japan
,
Shuntaro Yoshida
5   Endoscopy, Toyoshima Endoscopy Clinic, Setagaya-ku, Japan (Ringgold ID: RIN577428)
,
Yoshiyuki Takahashi
6   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
,
Hiroya Mizutani
7   Department of Gastroenterology, The University of Tokyo, Bunkyo-ku, Japan (Ringgold ID: RIN13143)
,
Hirotoshi Ebinuma
8   DEPARTMENT OF GASTROENTEROLOGY AND HEPATOLOGY, International University of Health and Welfare Mita Hospital, Minata-ku, Japan (Ringgold ID: RIN36767)
,
Mitsuhiro Fujishiro 
9   Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
10   Department of Gastroenterology, Graduate School of Medicine, the University of Toky,
,
Yutaka Saito
11   Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
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Backgrounds Among colorectal serrated polyps (SPs), sessile serrated lesions (SSLs) and hyperplastic polyps (HPs) show a similar endoscopic appearance. However, the endoscopic distinctions between the two categories, microvesicular HP (MVHP) and goblet cell-rich HP (GCHP) are not well understood. Therefore, we compared the endoscopic features of SSL, MVHP, and GCHP. Methods This retrospective, cross-sectional study was conducted at the Toyoshima Endoscopy Clinic. We examined the polyp size, location, Paris classification type, mucus cap, indistinct border, expanded crypt opening, varicose microvascular vessels, and JNET classification type. Multivariable analysis of each endoscopic finding using a binomial logistic regression model determined the factors that predicted SP histology. Results A total of 670 SPs were enrolled in this study, comprising 159 SSLs, 361 MVHPs, and 150 GCHPs. On comparing the SSL + MVHP group and GCHP, a mucus cap (partial regression coefficient 1.705), expanded crypt opening (1.828), and varicose microvascular vessels (1.270) were more often observed in SSL + MVHP group compared with GCHP. In the comparison between MVHP and GCHP, a mucus cap (1.564), expanded crypt opening (1.802), and varicose microvascular vessels (1.288) were more often found in MVHP in contrast to GCHP. When comparing SSL and MVHP, SSLs were more likely to be in the proximal colon (0.662) and were larger (0.198) than MVHPs. No significant differences were observed in other endoscopic findings. Conclusions SSL and MVHP have endoscopic appearances that differ from those of GCHP. Considering MVHP and GCHP as distinct entities may aid in the endoscopic diagnosis of SPs.



Publication History

Received: 06 November 2023

Accepted after revision: 02 April 2024

Accepted Manuscript online:
08 April 2024

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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