title: Global quantitative assessment of the colorectal polyp burden in familial adenomatous polyposis by using a web-based tool.
abstract: BACKGROUND
  Accurate measures of the total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video.
  
  
  OBJECTIVE
  To develop global quantitative tools of the FAP colorectal adenoma burden.
  
  
  METHODS
  A single-arm, phase II trial.
  
  
  METHODS
  Twenty-seven patients with FAP.
  
  
  METHODS
  Treatment with celecoxib for 6 months, with before-treatment and after-treatment videos posted to an intranet with an interactive site for scoring.
  
  
  METHODS
  Global adenoma counts and sizes (grouped into categories: <2 mm, 2-4 mm, and >4 mm) were scored from videos by using a novel Web-based tool. Baseline and end-of-study adenoma burden results were summarized by using 5 models. Correlations between pairs of reviewers were analyzed for each model.
  
  
  RESULTS
  Interobserver agreement was high for all 5 measures of polyp burden. Measures that used both polyp count and polyp size had better interobserver agreement than measures based only on polyp count. The measure in which polyp counts were weighted according to diameter, calculated as (1) × (no. of polyps <2 mm) + (3) × (no. of polyps 2-4 mm) + (5) × (no. of polyps >4 mm) had the highest interobserver agreement (Pearson r = 0.978 for two gastroenterologists, 0.786 and 0.846 for the surgeon vs each gastroenterologist). Treatment reduced the polyp burden by these measurements in 70% to 89% of patients (P < .001).
  
  
  CONCLUSIONS
  Phase II study.
  
  
  CONCLUSIONS
  This novel, Web-based polyp scoring method provides a convenient and reproducible way to quantify the global colorectal adenoma burden in FAP patients and a framework for developing a clinical staging system for FAP.
authors: Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA. plynch@mdanderson.org
authors: Patrick M
authors: PM
authors: Lynch
authors: Jeffrey S
authors: JS
authors: Morris
authors: William A
authors: WA
authors: Ross
authors: Miguel A
authors: MA
authors: Rodriguez-Bigas
authors: Juan
authors: J
authors: Posadas
authors: Rossa
authors: R
authors: Khalaf
authors: Diane M
authors: DM
authors: Weber
authors: Valerie O
authors: VO
authors: Sepeda
authors: Bernard
authors: B
authors: Levin
authors: Imad
authors: I
authors: Shureiqi
mesh_terms: D000236:Adenoma / Q000188:drug therapy / Q000473:pathology*; D011125:Adenomatous Polyposis Coli / Q000188:drug therapy / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000068579:Celecoxib; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D003195:Computer Communication Networks; D005260:Female; D006801:Humans; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D015588:Observer Variation; D011720:Pyrazoles / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D047368:Tumor Burden; D014741:Video Recording; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib