title: Endoscopic diagnosis of colorectal serrated lesions: Current status and future perspectives based on the results of a questionnaire survey.
abstract: Serrated lesions, especially sessile serrated adenoma/polyps (SSA/P) are considered one of the most important precursors of colorectal cancers. However, it is still difficult to endoscopically differentiate SSA/P from hyperplastic polyps. In the present review, we mainly focus on the current status and future perspectives of endoscopic diagnosis of colorectal serrated lesions based on the results of a questionnaire survey and report from the Endoscopic Forum Japan (EFJ) 2015 held in Tokyo in August 2015. The proposed diagnostic strategy recommended for colorectal serrated lesions is as follows. (i) For detection, use of an updated image-enhanced endoscopy system including autofluorescence imaging (AFI) and narrow-band imaging (NBI) may be promising. (ii) For differential diagnosis (hyperplastic polyp or SSA/P) of diminutive, small and large serrated lesions, NBI with magnification and magnifying chromoendoscopy using both indigocarmine and crystal violet should be applied, respectively. (iii) For differential diagnosis of SSA/P (with or without cytological dysplasia), magnifying chromoendoscopy, endocytoscopy and updated AFI system modalities might be promising.
authors: Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.|Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Takahisa
authors: T
authors: Matsuda
authors: Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
authors: Shiro
authors: S
authors: Oka
authors: Department of Gastrointestinal Oncology & Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan.
authors: Hiroaki
authors: H
authors: Ikematsu
authors: Digestive Disease Center, Akita Red Cross Hospital, Akita, Japan.
authors: Hiro-o
authors: HO
authors: Matsushita
authors: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors: Yuichi
authors: Y
authors: Mori
authors: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Yoji
authors: Y
authors: Takeuchi
authors: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
authors: Naoto
authors: N
authors: Tamai
authors: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors: Takuji
authors: T
authors: Kawamura
authors: Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors: Akiko
authors: A
authors: Chino
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors: Bora
authors: B
authors: Keum
authors: Gastrointestinal Endoscopy Excellent Center, Department of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
authors: Supakij
authors: S
authors: Khomvilai
authors: Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
authors: Toshio
authors: T
authors: Uraoka
mesh_terms: D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D011379:Prognosis; D011795:Surveys and Questionnaires
keywords: colonoscopy; endoscopic diagnosis; image-enhanced endoscopy; serrated lesion; sessile serrated adenoma/polyp (SSA/P)