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  • Hindawi Limited  (2)
  • Naito, Yuji  (2)
  • 1
    Online Resource
    Online Resource
    Pure Well-Differentiated Adenocarcinoma Is a Safe Factor for Lymph Node Metastasis in T1 and T2 Colorectal Cancer: A Pilot Study
    Hindawi Limited ; 2018
    In:  Gastroenterology Research and Practice Vol. 2018 ( 2018-11-18), p. 1-9
    Details
    In: Gastroenterology Research and Practice, Hindawi Limited, Vol. 2018 ( 2018-11-18), p. 1-9
    Abstract: Background and Aims . Various risk factors for lymph node metastasis (LNM) have been reported in colorectal T1 cancers. However, the factors available are insufficient for predicting LNM. We therefore investigated the utility of the new histological factor “pure well-differentiated adenocarcinoma” (PWDA) as a safe factor for predicting LNM in T1 and T2 cancers. Materials and Methods . We reviewed 115 T2 cancers and 202 T1 cancers in patients who underwent surgical resection in our center. We investigated the rates of LNM among various clinicopathological factors, including PWDA. PWDA was defined as a lesion comprising only well-differentiated adenocarcinoma. The consistency of the diagnosis of PWDA was evaluated among two pathologists. In addition, 72 T1 cancers with LNM from 8 related hospitals over 10 years (2008–2017) were also analyzed. Results . The rates of LNM and PWDA were 23.5% and 20.0%, respectively, in T2 cancers. Significant differences were noted between patients with and without LNM regarding lymphatic invasion (81.5% vs. 36.4%, p 〈 0.001 ), poor histology (51.9% vs. 19.3%, p = 0.008 ), and PWDA (3.7% vs. 25.0%, p = 0.015 ). The rates of LNM and PWDA were 8.4% and 36.1%, respectively, in T1 cancers. Regarding the 73 PWDA cases and 129 non-PWDA cases, the rates of LNM were 0.0% and 13.2%, respectively ( p 〈 0.001 ). Among the 97 cases with lymphatic or venous invasion, the rates of LNM in 29 PWDA cases and 68 non-PWDA were 0% and 14.7%, respectively ( p = 0.029 ). The agreement of the two pathologists for the diagnosis of PWDA was acceptable (kappa value  〉  0.5). A multicenter review showed no cases of PWDA among 72 T1 cancers with LNM. Conclusions . PWDA is considered to be a safe factor for LNM in T1 cancer.
    Type of Medium: Online Resource
    ISSN: 1687-6121 , 1687-630X
    URL: Article
    DOI: 10.1155/2018/8798405
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2018
    detail.hit.zdb_id: 2435460-0
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Additional Thirty Seconds Observation with Linked Color Imaging Improves Detection of Missed Polyps in the Right-Sided Colon
    Hindawi Limited ; 2018
    In:  Gastroenterology Research and Practice Vol. 2018 ( 2018-07-08), p. 1-8
    Details
    In: Gastroenterology Research and Practice, Hindawi Limited, Vol. 2018 ( 2018-07-08), p. 1-8
    Abstract: Background and Aims . Missed polyps are a pitfall of colonoscopy. In this study, we analyzed the efficacy of an additional 30 seconds observation using linked color imaging (LCI) for detecting adenoma and sessile serrated adenoma/polyp (SSA/P). Materials and Methods . We enrolled patients undergoing colonoscopy from February to October 2017 in two institutions. In all patients, the cecum and ascending colon were observed with white light imaging (WLI) first. The colonoscope was inserted again, and the cecum and ascending colon were observed for an additional 30 seconds using either LCI or WLI. The method for the 30 sec observation was to insufflate the cecum and ascending colon sufficiently and observe them in a distant view, because the length of the second observation was determined to be precisely 30 sec. For the second observation, LCI was performed for the first 65 patients and WLI for the next 65. Adenoma and SSA/P detection rate (ASDR) in the second observation were examined in both groups. According to a pilot study, the sample size was estimated 65. Results . In the first observation, ASDR were 30.7% in the LCI group and 32.2% in the WLI group ( p = 0.85 ). For the second observation, 13 polyps were detected in the LCI group and 5 polyps in the WLI group ( p = 0.04 ). Additionally, ASDR for the second observation were 18.5% and 6.1%, respectively ( p = 0.03 ). There were no significant differences between the LCI and WLI groups with respect to morphology (ratio of polypoid) (38.5% versus 60.0%, p = 0.52 ) and histology (ratio of adenoma) (92.3% versus 100.0%, p = 0.91 ). Total adenoma and SSA/P number were 48 in the LCI group and 36 in the WLI group ( p = 0.02 ). Conclusion . The 30 seconds additional observation with LCI improved the detection of adenoma and SSA/P in the right-sided colon.
    Type of Medium: Online Resource
    ISSN: 1687-6121 , 1687-630X
    URL: Article
    DOI: 10.1155/2018/5059834
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2018
    detail.hit.zdb_id: 2435460-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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