Features Of Polyps Research Articles

HPB SO36 - Diagnostic Accuracy in Detecting Gall Bladder Polyps: A Retrospective Study

Abstract Background Gallbladder polyps are outgrowths of the gallbladder mucosal wall. They are usually found incidentally on ultrasonography or after cholecystectomy, but can lead to symptoms similar to those caused by gallbladder stones1. It is important to differentiate pseudo-polyps (cholesterol, adenomyomatosis, inflammatory, hyperplastic) from true-polyps (adenomas, adenocarcinomas2,3). The vast majority of polyps detected by ultrasound are pseudo-polyps, with no risk of malignancy. Ultrasound has been considered the gold standard for diagnosis,. However, it is limited by several factors4,5. The primary objective of this study is to assess the accuracy of ultrasound in diagnosing true polyps in patients undergoing surgery for this condition. Method Retrospective review carried out on all US scans reporting Gallbladder polyps for patients who underwent cholecystectomy, with additional data from MRI and CT scans. Sample size 44 patients Time period: From 2019 to present. Analysis was done on Excel Inclusion Criteria: Patients who had cholecystectomies with USS results confirming GB polyps, and have histology reports.Patients who had cholecystectomies with USS results confirming GB stones, and polyps as a co-existing pathology, and have histology reports. Results We included 44 patients our study, all had polyps on USS, and elective laparoscopic cholecystectomy, the mean age was 52 Years, and 63.6 % were women. Out of 44 USS patients, 24 (54.5%) showed features of polyps on histopathology. However, only 6 (13.6%) specimens were identified as adenomas. 18 USS showed polyps measuring 10mm or more. The majority (55.6%) were benign pathologies (pseudo-polyps). Interestingly, only 3 showed features of adenomas (16.7%). 22 Patients had multiple USS for surveillance, Histology showed polyps in 12 specimens (54.5%), out of which only 4 were adenomas (18.2%). Conclusion The accuracy of transabdominal ultrasound in diagnosing true polyps is limited. However, the sensitivity to distinguish adenomas slightly increases in larger polyps This low diagnostic accuracy underscores the need for caution among surgeons when making clinical decisions based on ultrasound-detected polyps. The high false positive rate suggests that more diagnostic criteria are necessary to improve the reliability of ultrasound in the diagnosis and screening of polyps, which is crucial to help reduce unnecessary procedures in asymptomatic patients who had negative histology reports postoperatively.

CATNet: A Cross Attention and Texture‐Aware Network for Polyp Segmentation

ABSTRACTPolyp segmentation is a challenging task, as some polyps exhibit similar textures to surrounding tissues, making them difficult to distinguish. Therefore, we present a parallel cross‐attention and texture‐aware network to address this challenging task. CATNet incorporates the parallel cross‐attention mechanism, Residual Feature Fusion Module, and texture‐aware module. Initially, polyp images undergo processing in our backbone network to extract multi‐level polyp features. Subsequently, the parallel cross‐attention mechanism sequentially captures channel and spatial dependencies across multi‐scale polyp features, thereby yielding enhanced representations. These enhanced representations are then input into multiple texture‐aware modules, which facilitate polyp segmentation by accentuating subtle textural disparities between polyps and the background. Finally, the Residual Feature Fusion module integrates the segmentation results with the previous layer of enhanced representations. This process serves to eliminate background noise and enhance intricate details. We assess the efficacy of our proposed method across five distinct polyp datasets. On three unseen datasets, CVC‐300, CVC‐ColonDB, and ETIS. We achieve mDice scores of 0.916, 0.817, and 0.777, respectively. Experimental results unequivocally demonstrate the superior performance of our approach over current models. The proposed CATNet addresses the challenges posed by textural similarities, setting a benchmark for future advancements in automated polyp detection and segmentation.

Frequency of Errors in Colorectal Lesion Description and Management Prior to Referral to A Tertiary Center

Background and AimsAccurate reporting of polyp characteristics is crucial for effective resource allocation in endoscopic resection referrals. We present our experience with pre-referral management of challenging colorectal lesions. MethodsWe reviewed a prospectively collected database of consecutive referrals for endoscopic resection of challenging colorectal lesions. The database included details of prior colonoscopies. We assessed pre-referral management using established guidelines. ResultsAmong 1,826 referred lesions in 1826 patients, size estimates were missing for 421 (24%) lesions; 56 (3.2%) were found twice as large as previously estimated, while 65 (3.7%) were half the previous estimate. Morphological descriptions were absent for 376 (22%) polyps. Tattooing was performed for 822 (47%) lesions, with 247 (30%) placed correctly. Of the 1,103 (77%) polyps biopsied, only 11 (1.1%) were classified as high-risk by the referring endoscopist. ConclusionsErrors in pre-referral management of challenging colorectal lesions are frequent. Improved adherence to national guidelines could enhance practice.

S444 New Territories: Exploring Polyp Characteristics in Adult Colonoscopy Patients Within a Large Community Setting

S444 New Territories: Exploring Polyp Characteristics in Adult Colonoscopy Patients Within a Large Community Setting

Revisiting the etiology and clinical characteristics of hemorrhagic polyps of the vocal fold.

Benign phonotraumatic lesions of the vocal folds (BVFLs) are typically seen in younger female patients with high vocal loads. Hemorrhagic polyps (HPs) do not fit the classic paradigm of most BVFLs, as they tend to occur in an older population, have a male predominance, and report to result from a vocal accident. We present one of the largest cohorts of HPs, to reexamine their etiology and clinical features. Retrospective cohort study, inclusive of all patients with HP managed by the senior authors between the years 2016 through 2023. Demographic data, management, phonotraumatic risk factors, pre- and post-treatment VHI-10 were reviewed. We examined patient videostroboscopy, categorized the size of the lesion, and identified any concurrent mucosal abnormality. One hundred and eleven patients had confirmed HP, 84 males (75.7%). Thirty-five patients were size category 1; pinpoint (28.9%), 57 were category 2; less than 1/3rd the vocal fold (45.5%), and 26 were category 3; greater than 1/3rd the vocal fold (21.5%). Ten patients (9%) had bilateral HPs. Thirty-five patients had an additional 40 mucosal lesions in addition to the HP(s). The onset of symptoms was gradual in 60% of patients. The mean pretreatment VHI-10 was 18.0 (SD 10.7), compared to 6.0 (SD 10.5) post-treatment, (p < .001). 57/111 patients reported high voice demand professions or recreational activities. The average self-reported talkative scale score was 7.6/10. Patients were managed with operative microdirect laryngoscopy and microflap excision (53.1%), in-office clinic potassium titanyl phosphate (KTP) laser (24.3%), voice therapy alone (7.2%), and KTP in the operating room (6.3%). In our cohort, most patients were male, had high vocal demands, reported gradual symptom onset, and almost a third of patients had additional BVFLs. Level 3: Retrospective cohort study.

Sonographic Characteristics of ≥7 mm Gallbladder Polyps: A Retrospective Analysis.

To describe the sonographic characteristics of gallbladder polyps measuring ≥7 mm focusing on echogenicity, correlate with surgical pathology when available, and assess stability in size over time. This retrospective study used a natural language processing application to screen ultrasound (US) reports between January 1, 2012, and December 31, 2020, that contained the words "gallbladder polyp" or "polyps." Reports were reviewed to identify polyps ≥7 mm. The most hyperechoic components of the polyps were compared to the adjacent inner wall of the gallbladder and categorized as more echogenic, isoechoic, and less echogenic. Other sonographic characteristics such as heterogeneity, sessile configuration, vascularity, multiplicity, presence of gallstones, and wall thickening were recorded. Surgical pathology reports were reviewed when available. Polyps in nonsurgical patients with ≥48-month US follow-up and ≤1 mm/year growth rate were characterized as benign. Clinical outcomes were followed until December 31, 2023. Review of 4897 reports yielded 550 reports in 450 patients with polyps ≥7 mm. Surgical pathology reports were available in 22.0% (99/450) of patients; 96 (97%) had non-neoplastic etiologies and 3 (3.0%) neoplastic. There were no malignancies. All of the neoplastic polyps and 56.1% (87/155) of non-neoplastic polyps had components more echogenic than the adjacent inner wall. There were no deaths related to the polyps. The vast majority of gallbladder polyps are benign. In our large series of gallbladder polyps, we found that increased echogenicity is a nonspecific feature, found in slightly more than half of benign but also in all neoplastic polyps. Our findings support current Society of Radiologists in Ultrasound consensus guidelines.

Impact of User's Background Knowledge and Polyp Characteristics in Colonoscopy with Computer-Aided Detection.

We investigated how interactions between humans and computer-aided detection (CADe) systems are influenced by the user's experience and polyp characteristics. We developed a CADe system using YOLOv4, trained on 16,996 polyp images from 1,914 patients and 1,800 synthesized sessile serrated lesion (SSL) images. The performance of polyp detection with CADe assistance was evaluated using a computerized test module. Eighteen participants were grouped by colonoscopy experience (nurses, fellows, and experts). The value added by CADe based on the histopathology and detection difficulty of polyps were analyzed. The area under the curve for CADe was 0.87 (95% confidence interval [CI], 0.83 to 0.91). CADe assistance increased overall polyp detection accuracy from 69.7% to 77.7% (odds ratio [OR], 1.88; 95% CI, 1.69 to 2.09). However, accuracy decreased when CADe inaccurately detected a polyp (OR, 0.72; 95% CI, 0.58 to 0.87). The impact of CADe assistance was most and least prominent in the nurses (OR, 1.97; 95% CI, 1.71 to 2.27) and the experts (OR, 1.42; 95% CI, 1.15 to 1.74), respectively. Participants demonstrated better sensitivity with CADe assistance, achieving 81.7% for adenomas and 92.4% for easy-to-detect polyps, surpassing the standalone CADe performance of 79.7% and 89.8%, respectively. For SSLs and difficult-to-detect polyps, participants' sensitivities with CADe assistance (66.5% and 71.5%, respectively) were below those of standalone CADe (81.1% and 74.4%). Compared to the other two groups (56.1% and 61.7%), the expert group showed sensitivity closest to that of standalone CADe in detecting SSLs (79.7% vs 81.1%, respectively). CADe assistance boosts polyp detection significantly, but its effectiveness depends on the user's experience, particularly for challenging lesions.

Clinical characteristics of appendix orifice polyps and the effect endoscopic super minimally invasive treatment

To analyze the clinical characteristics of appendiceal orifice polyps and the effect of endoscopic super minimally invasive treatment. A retrospective analysis was conducted on the general situation (age and sex), the classification of appendiceal orifice polyps, the treatment method under endoscope, postoperative pathology and postoperative complications in patients who underwent resection of appendiceal orifice polyps at the Peking University First Hospital and the First Medical Center of the PLA General Hospital from January 1, 2022, to December 31, 2023. A total of 47 patients were included, consisting of 28 males and 19 females, with 35-86 (61±12) years. Appendiceal orifice polyps were classified into four types: type 0 (14 cases), type 1 (15 cases), type 2 (12 cases), and type 3 (6 cases). Among the endoscopic morphologies, 22 cases were granular laterally spreading tumors. Endoscopic mucosal dissection was performed in 37 cases. Postoperative appendiceal stent placement was performed in 1 case. The pathological types of polyps included adenoma in 15 cases, high-grade intraepithelial neoplasia in 10 cases, intramucosal carcinoma in 4 cases, submucosal carcinoma in 5 cases, inflammatory polyps in 1 cases, and sessile serrated lesion in 12 cases. Curative resection was performed in 44 cases. There were no postoperative complications such as bleeding, perforation, or acute appendicitis. The pathology of appendiceal polyps is mostly precancerous lesions, and the treatment scheme of endoscopic super minimally invasive resection is both safe and effective.

FP1.3 - SPEC MDT in Aneurin Bevan University Health Board

Abstract Aims The SPEC (significant polyp and early cancer) multi-disciplinary team (MDT) meeting was started in ABUHB in 2022 to discuss complex colonic and rectal polyp cases, such as polyps &amp;gt;20mm, likely to be sessile, or difficult to remove endoscopically. The aim was to evaluate the effectiveness and clinical role of the SPEC MDT. Methods Data for patients discussed in SPEC MDT since its conception in January 2022 until September 2023 was retrospectively collected from the SPEC MDT database, a prospectively collected database. This included patient demographics, reason for referral, polyp characteristics and MDT outcomes. Results In 21 months, there have been 38 SPEC MDTs, with 355 cases discussed (average of 9 cases per MDT). There was at least one laparoscopic colorectal surgeon, gastroenterologist and a histopathologist in every MDT in accordance with BSG guidelines. Main referral reasons included endoscopy findings (72%) and re-discussion post-procedure (22%). Twenty-three patients had adenocarcinomas and three had NETs. MDT outcomes were EMR (23%), endoscopic surveillance (21%), clinic to discuss (no) surgery (19%), TAMIS (16%), urgent endoscopy (13%) or other (8%). Conclusion As the busiest Health Board in Wales for Colorectal Cancers, the formation of SPEC MDT has been an important step in improving the detection and treatment of advanced polyps and early cancers. Although too early to measure the impact on early cancer detection rates and improved decision making for these patients, formalising the MDT process in line with BSG guidelines has been an important step in improving the service offered to patients.

Polypoid Kaposi Sarcoma Involving the Lower Gastrointestinal Tract: Clinicopathologic Study of 15 Cases.

Gastrointestinal manifestations of Kaposi sarcoma are rare but may cause morbidity. Lower gastrointestinal involvement is particularly rare and lesions may resemble conventional bowel polyps. To study 15 patients who presented with lower gastrointestinal tract Kaposi sarcoma with polypoid architecture. The surgical pathology files of the departments of pathology at multiple institutions were searched for cases of Kaposi sarcoma forming polyps in the lower gastrointestinal tract (jejunum, colon, rectum); 15 cases with such features were identified. Clinicopathologic information was extracted from the medical record and documented by reviewing individual hematoxylin-eosin stained slides. The patients were 13 men and 2 women aged 26-80 years (median = 44 years). Gastrointestinal tract involvement was multifocal in 11 cases and unifocal in 4. The tumors involved the rectum, recto-sigmoid junction, cecum, ascending colon, transverse colon, and descending colon and presented as polypoid lesions measuring 0.2-2.1 cm. Six patients had upper gastrointestinal tract involvement in addition to lower gastrointestinal lesions. Histologically the tumors were characterized in 6 cases by a dense spindle cell proliferation in the lamina propria; however, the remaining cases showed only a subtle fascicular spindle cell proliferation in the lamina propria that did not form an expansile mass. Biopsies of gastrointestinal polyps showing absence of the common features of hyperplastic or adenomatous polyps, particularly in immunocompromised patients, should be carefully examined for the presence of a stromal spindle cell proliferation. Use of immunohistochemical stains, particularly human herpesvirus-8, can help in establishing the correct diagnosis.

The Use of Clips to Prevent Post-Polypectomy Bleeding: A Clinical Review.

The goal of this clinical review is to provide an overview of the current literature regarding the utility of prophylactic clips in reducing postpolypectomy bleeding and to provide an expert statement regarding their appropriateness in clinical practice. Colonoscopy enables the identification and removal of premalignant and malignant lesions through polypectomy, yet complications including postpolypectomy bleeding (PPB) can arise. While various studies have explored applying clips prophylactically to prevent PPB, their effectiveness remains uncertain. A literature search conducted in PubMed and Embase identified 671 publications discussing clip use postpolypectomy; 67 were found to be relevant after screening, reporting outcomes related to PPB. Data related to clip utilization, polyp characteristics, and adverse events were extracted and discussed. The current literature suggests that prophylactic clipping is most beneficial for nonpedunculated polyps ≥20mm, especially those in the proximal colon. The utility of clipping smaller polyps and those in the distal colon remains less clear. Antithrombotic medication usage, particularly anticoagulants, has been linked to an increased risk of bleeding, prompting consideration for clip placement in this patient subgroup. While cost-effectiveness analyses may indicate potential savings, the decision to clip should be tailored to individual patient factors and polyp characteristics. Current research suggests that the application of prophylactic clips can be particularly beneficial in preventing delayed bleeding after removal of large nonpedunculated polyps, especially for those in the proximal colon and in patients on antithrombotic medications. In addition, for large pedunculated polyps prophylactic clipping is most effective at controlling immediate bleeding.

Histopathological Features of Colorectal Polyps and Tumors at Sumber Waras Hospital from 2015-2023

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Colorectal tumours pose a significant global health issue, including in Indonesia. The development of colorectal polyps and tumours involves various risk factors such as poor lifestyle choices, male gender, and advancing age. This study aims to determine the characteristics of patients with colorectal polyps and tumours, their histopathological features, and the most common gender and age group for each histopathological feature. The study was conducted at Sumber Waras Hospital, implementing a descriptive cross-sectional approach with retrospective data of 113 patients with colorectal polyps and tumours from 2015-2023. This study's findings indicate that most patients were males (58.4%), with the highest number in the 61-70 age group (29.2%). Among non-neoplastic lesions, inflammatory polyp was the most prevalent histopathological finding (18.3%), whereas adenocarcinoma (NOS) was the most common feature among all neoplastic lesions (53.3%). All non-neoplastic lesions were predominantly found in males. Neoplastic lesions such as adenocarcinoma (NOS), mucinous adenocarcinoma, neuroendocrine tumours, and lymphoma were also more prevalent in males. In contrast, adenoma, signet ring, and squamous cell carcinoma were more frequently found in females. Non-neoplastic lesions such as hamartoma were most common in the 11-20 age group, while hyperplastic and inflammatory polyps were prevalent in the 61-70 age group. Neoplastic lesions such as adenoma were most prevalent in the 61-70 and 71-80 age groups; mucinous adenocarcinoma and lymphoma in the 51-60 age group; adenocarcinoma (NOS), squamous cell carcinoma, and neuroendocrine tumours in the 61-70 age group; as well as signet ring cell carcinoma in the 71-80 age group. To reduce the prevalence of colorectal polyps and tumours, it may be crucial to consider performing histopathological examinations for a thorough evaluation, given their wide variety that requires different diagnostic and treatment strategies. &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p class="TableParagraph"&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: Age Group, Colorectal Polyp, Colorectal Tumor, Gender, Histopathological Features&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

DHAFormer: Dual-channel hybrid attention network with transformer for polyp segmentation.

The accurate early diagnosis of colorectal cancer significantly relies on the precise segmentation of polyps in medical images. Current convolution-based and transformer-based segmentation methods show promise but still struggle with the varied sizes and shapes of polyps and the often low contrast between polyps and their background. This research introduces an innovative approach to confronting the aforementioned challenges by proposing a Dual-Channel Hybrid Attention Network with Transformer (DHAFormer). Our proposed framework features a multi-scale channel fusion module, which excels at recognizing polyps across a spectrum of sizes and shapes. Additionally, the framework's dual-channel hybrid attention mechanism is innovatively conceived to reduce background interference and improve the foreground representation of polyp features by integrating local and global information. The DHAFormer demonstrates significant improvements in the task of polyp segmentation compared to currently established methodologies.

A semantic feature enhanced YOLOv5-based network for polyp detection from colonoscopy images

Colorectal cancer (CRC) is a common digestive system tumor with high morbidity and mortality worldwide. At present, the use of computer-assisted colonoscopy technology to detect polyps is relatively mature, but it still faces some challenges, such as missed or false detection of polyps. Therefore, how to improve the detection rate of polyps more accurately is the key to colonoscopy. To solve this problem, this paper proposes an improved YOLOv5-based cancer polyp detection method for colorectal cancer. The method is designed with a new structure called P-C3 incorporated into the backbone and neck network of the model to enhance the expression of features. In addition, a contextual feature augmentation module was introduced to the bottom of the backbone network to increase the receptive field for multi-scale feature information and to focus on polyp features by coordinate attention mechanism. The experimental results show that compared with some traditional target detection algorithms, the model proposed in this paper has significant advantages for the detection accuracy of polyp, especially in the recall rate, which largely solves the problem of missed detection of polyps. This study will contribute to improve the polyp/adenoma detection rate of endoscopists in the process of colonoscopy, and also has important significance for the development of clinical work.

Molecular profiling of visible polypoid and invisible conventional intestinal-type low-grade dysplasia in patients with idiopathic inflammatory bowel disease

AimsLittle is known about the molecular features of visible polyps with low-grade intestinal-type dysplasia in patients with inflammatory bowel disease (IBD). To better understand their origins and biological potential, we...

Ectodermal origin and tissue dedifferentiation in the podocyst production by the polyps of the Asian moon jelly (Aurelia coerulea).

The histological origin of podocysts in scyphozoans has long been undetermined, with uncertainty whether they arise from mesenchymal amoebocytes or stalk and pedal disc ectoderm in polyps. Histological investigation on the pedal disc was difficult due to the settlement of polyps on hard substrates. In this study, we investigated the histological characteristics of polyps during podocyst production in Asian moon jelly (Aurelia coerulea) with utilizing those attached on thin polystyrene substrates. Fine histological features of the pedal disc became possible after the substrates were decomposed during histological processing. Our findings unequivocally demonstrate that the cell mass of podocysts originates from the ectoderm of the pedal disc and the stalk without the involvement of amoebocytes in the mesoglea. Preceding the podocyst formation, the pedal disc undergoes enlargement facilitated by the elongated stalk ectodermal cells, which attach to a substrate. Subsequently, the pedal disc ectoderm give rise to the primary podocyst cells with accumulating nutrient granules in the cytoplasm and forming the cyst capsule cooperatively with the invaginated pedal disc ectoderm. Direct transformation from the ectodermal cells to podocyst cells suggests that podocyst formation involves tissue dedifferentiation. Throughout the period of podocyst production, the gastrodermis of polyps is physically separated from the ectoderm by the mesoglea and shows no histological changes, and no amoebocytes appear in the mesoglea. These histological properties are totally different from those in other modes of asexual reproduction, which incorporate the endoderm of polyps, suggesting the developmental and evolutionary differences between these asexual reproductions and podocyst production in Scyphozoa.

LightCF-Net: A Lightweight Long-Range Context Fusion Network for Real-Time Polyp Segmentation.

Automatically segmenting polyps from colonoscopy videos is crucial for developing computer-assisted diagnostic systems for colorectal cancer. Existing automatic polyp segmentation methods often struggle to fulfill the real-time demands of clinical applications due to their substantial parameter count and computational load, especially those based on Transformer architectures. To tackle these challenges, a novel lightweight long-range context fusion network, named LightCF-Net, is proposed in this paper. This network attempts to model long-range spatial dependencies while maintaining real-time performance, to better distinguish polyps from background noise and thus improve segmentation accuracy. A novel Fusion Attention Encoder (FAEncoder) is designed in the proposed network, which integrates Large Kernel Attention (LKA) and channel attention mechanisms to extract deep representational features of polyps and unearth long-range dependencies. Furthermore, a newly designed Visual Attention Mamba module (VAM) is added to the skip connections, modeling long-range context dependencies in the encoder-extracted features and reducing background noise interference through the attention mechanism. Finally, a Pyramid Split Attention module (PSA) is used in the bottleneck layer to extract richer multi-scale contextual features. The proposed method was thoroughly evaluated on four renowned polyp segmentation datasets: Kvasir-SEG, CVC-ClinicDB, BKAI-IGH, and ETIS. Experimental findings demonstrate that the proposed method delivers higher segmentation accuracy in less time, consistently outperforming the most advanced lightweight polyp segmentation networks.

Identification and Predictive Analysis of Colorectal Polyps Using Flexible Sigmoidoscopy: A Retrospective Cohort Study

Background: Colorectal polyps are mucosal growths in the colon and rectum that may progress to cancer if not removed early. Flexible sigmoidoscopy is a common diagnostic tool for detecting these polyps, particularly in symptomatic patients, though predictive factors in younger populations remain unclear. Objective: This study aims to analyze the characteristics of colorectal polyps diagnosed via flexible sigmoidoscopy and identify predictive factors for their presence. Materials and Methods: We conducted a retrospective study on 1004 patients who underwent sigmoidoscopy from August 2023 to February 2024 at Ghurki Trust &amp; Teaching Hospital, Lahore, Pakistan. The study included data from 84 patients diagnosed with colorectal polyps. Analyzed variables were age, gender, polyp count, type (pedunculated or sessile), distribution, and indications for sigmoidoscopy (bleeding vs. other). Statistical analysis using SPSS version 15 included chi-square tests and odds ratios to identify significant associations. Results: Colorectal polyps were detected in 8.4% of patients, with a gender distribution of 7.9% in males and 8.4% in females. Sessile polyps predominated at 64.3%, and the majority of polyps were solitary (75%). Polyps primarily affected the rectum (53.6%) and were less frequently found in the sigmoid colon (21.4%), rectosigmoid junction (17.9%), and descending colon (7.1%). Significant predictors of polyp detection included age (45% in children vs. 6.5% in adults, p &lt; 0.001) and indication for sigmoidoscopy (14% in cases of rectal bleeding vs. 3.3% for other reasons, p &lt; 0.001). Gender was not a significant factor (p=0.467). Conclusion: Sigmoidoscopy effectively detects colorectal polyps, particularly in symptomatic children and those with rectal bleeding. This highlights the need for targeted screening to improve early detection and management. Further research is required to validate these findings and refine screening guidelines.

Artificial Intelligence for Real-Time Prediction of the Histology of Colorectal Polyps by General Endoscopists.

Real-time prediction of histologic features of small colorectal polyps may prevent resection and/or pathologic evaluation and therefore decrease colonoscopy costs. Previous studies showed that computer-aided diagnosis (CADx) was highly accurate, though it did not outperform expert endoscopists. To assess the diagnostic performance of histologic predictions by general endoscopists before and after assistance from CADx in a real-life setting. Prospective, multicenter, single-group study. (ClinicalTrials.gov: NCT04437615). 6 centers across the United States. 1252 consecutive patients undergoing colonoscopy and 49 general endoscopists with variable experience in real-time prediction of polyp histologic features. Real-time use of CADx during routine colonoscopy. The primary end points were the sensitivity and specificity of CADx-unassisted and CADx-assisted histologic predictions for adenomas measuring 5 mm or less. For clinical purposes, additional estimates according to location and confidence level were provided. The CADx device made a diagnosis for 2695 polyps measuring 5 mm or less (96%) in 1252 patients. There was no difference in sensitivity between the unassisted and assisted groups (90.7% vs. 90.8%; P = 0.52). Specificity was higher in the CADx-assisted group (59.5% vs. 64.7%; P < 0.001). Among all 2695 polyps measuring 5 mm or less, 88.2% and 86.1% (P < 0.001) in the CADx-assisted and unassisted groups, respectively, could be resected and discarded without pathologic evaluation. Among 743 rectosigmoid polyps measuring 5 mm or less, 49.5% and 47.9% (P < 0.001) in the CADx-assisted and unassisted groups, respectively, could be left in situ without resection. Decision making based on CADx might differ outside a clinical trial. CADx assistance did not result in increased sensitivity of optical diagnosis. Despite a slight increase, the specificity of CADx-assisted diagnosis remained suboptimal. Olympus America Corporation served as the clinical study sponsor.

Histopathological comparison of colorectal neoplasia or polyps development between young adults and older adults: Our experience of 735 consecutive cases and 1269 polyps.

In recent decades, there has been an increase in early-onset colorectal cancer, the need to screen individuals younger than 50 years of age, and the presence of histopathological differences remains unclear. The objective of this study was to explore the occurrence of polyps in both young adults and older individuals and to examine their potential correlation with colorectal cancer. In this retrospective study conducted between July 1, 2018, and October 5, 2022, in the Pathology Laboratory, we designed a study based on the histopathological features of colorectal polyps evaluated by an experienced gastrointestinal pathologist based on the WHO 2019 classification. We evaluated 735 consecutive patients who underwent colonoscopic polypectomy between July 2018 and October 2022. The prevalence of cases under the age of 50 was 13.9%, and adults over the age of 50 was 86.1%. A total of 1269 polyps were detected, 1215 (95.7%) were epithelial polyps and 145 (11.9%) were epithelial polyps under the age of 50. One hundred four conventional adenomas and four intramucosal carcinomas were detected in cases younger than 50 years. The patients in the low-risk adenoma group was 57%, and the rate of patients in the high-risk adenoma group was 14.9%. Overall, polyps were most common in the sigmoid colon and there was a statistically significant difference between detecting tubular adenomas in the sigmoid colon (P=0.04). Our current results confirm the detection of sporadic colorectal adenomas and advanced neoplasia in young adults.It is important to establish professional community guidelines for surveillance colonoscopy in these age groups.