title: Efficiency of endocytoscopy in differentiating types of serrated polyps.
abstract: BACKGROUND
  Accurate endoscopic criteria are needed to differentiate serrated polyps, including hyperplastic polyp (HP), sessile serrated adenoma/polyp (SSA/P), and traditional serrated adenoma (TSA), because some are precursors of colorectal cancers.
  
  
  OBJECTIVE
  To determine the endocytoscopic features of each type of serrated polyp, especially the shapes of lumens and nuclei.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Single, tertiary-care referral center.
  
  
  METHODS
  Patients who underwent removal of serrated polyps from May 2005 to December 2012.
  
  
  METHODS
  Endocytoscopy was performed. Endocytoscopic images were evaluated by assessing the shapes of the lumens and nuclei of the target lesions.
  
  
  METHODS
  The significant endocytoscopic features in differentiating among types of serrated polyps.
  
  
  RESULTS
  Of the 58 eligible lesions, 27 were classified as HP, 12 as SSA/P, and 19 as TSA. Most HPs (77.8%) had star-like lumens, and most SSA/Ps (83.3%) had oval lumens. The lumens of TSAs were serrated (31.6%) or villous (68.4%), with both shapes seen only in TSAs. Most HPs (92.6%) and SSA/Ps (75.0%) had small, round nuclei, and all TSAs had fusiform nuclei. Features significantly differentiating TSAs from HPs and SSA/Ps were the presence of fusiform nuclei (P < .001) and villous (P < .001) and serrated (P = .002) lumens. The presence of oval lumens was significantly characteristic of SSA/Ps (P < .001), and the presence of star-like lumens was significantly characteristic of HPs (P < .001).
  
  
  CONCLUSIONS
  Retrospective design. Single-center study.
  
  
  CONCLUSIONS
  The shape of lumens and nuclei on endocytoscopy can efficiently differentiate among the different types of serrated polyps. (
  
  
  BACKGROUND
  UMIN Clinical Trials Registry UMIN000007850.).
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kutsukawa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shin-Ei
authors.initials: SE
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Nobunao
authors.initials: N
authors.lastname: Ikehara
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Wakamura
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Katsuro
authors.initials: K
authors.lastname: Ichimasa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Misawa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Wada
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Takemasa
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyachi
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Hamatani
mesh_terms: D003111:Colonic Polyps / Q000473:pathology*; D020685:Colonoscopes; D003113:Colonoscopy; D004867:Equipment Design; D006801:Humans; D012189:Retrospective Studies