title: Characterization of the pathologic and endoscopic measurements of colorectal polyp sizes with a focus on sessile serrated adenoma and high-grade dysplasia.
abstract: BACKGROUND
  The characteristics of pathologically measured (PMS) and endoscopically measured sizes (EMS) of the colorectal polyps (CRPs) is poorly understood, particularly in polypoid unremarkable mucosa (PUM), sessile serrated adenoma (SSA), and high-grade dysplasia (HGD).
  
  
  METHODS
  To characterize the discordance and correlation between the PMS and EMS of CRPs including PUM, SSA, HGD, hyperplastic polyp (HP) and adenomas, we conducted this prospective observational study on the polyps collected between August 2012 and December 2013.
  
  
  RESULTS
  PMS was significantly smaller than EMS in the 497 qualified CRPs regardless of the sites (left, transverse and right colorectum) or EMS (≥1 cm and <1 cm) subgroups. The PMS and EMS discordance was associated with a diagnosis of HP and adenoma (versus PUM, SSA or HGD), single fragment (versus multiple), 3 of the 8 endoscopists and PMS<1 cm (versus ≥1 cm). Despite a good correlation between EMS and PMS in the adenomas (ĸ=0.626, 95% confidence intervals [CI], 0.505-0.746) and a moderate correlation in the serrated polyps (SPs) including HP and SSA, (ĸ=0.424, 95% CI, 0.244-0.604), 40.4% (23/57) of the adenomas and 63.6% (21/33) of the SPs with EMS≥1 cm might warrant longer follow-up intervals since their PMS were <1 cm. The PMS and EMS had linear correlations except in CRPs with HGD or EMS≥1 cm.
  
  
  CONCLUSIONS
  The discordance between PMS and EMS is associated with the pathologic diagnosis, fragment number, endoscopists and PMS, and may lead to different follow-ups in a considerable portion of adenomas and SPs.
authors.affiliation: Department of Gastroenterology and Hepatology, Chinese PLA General Hospital Beijing, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Chemical Process Development and Commercialization, Merck & Co. Rahway, NJ.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Medicine, University of Maryland School of Medicine Baltimore, MD.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Pathology, Tongji Hospital, Tongji University School of Medicine Shanghai, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Yi
authors.affiliation: Department of Gastroenterology and Hepatology, Chinese PLA General Hospital Beijing, China.
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Pathology, University Medical Center of Princeton Plainsboro, NJ ; Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers University Piscataway, NJ ; Department of Pathology, Robert Wood Johnson Medical School, Rutgers University Piscataway, NJ ; Cancer Institute of New Jersey, Rutgers University Piscataway, NJ.
authors.forename: Lanjing
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000368:Aged; D001706:Biopsy; D003111:Colonic Polyps / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: Polyp; cancer; colonoscopy; measurement; pathology; surveillance