We classified neoplasia into five categories on the basis of the histological findings and whether the neoplasia was located in colitis-affected segments, as follows: serrated polyps in colitis-affected segments, conventional dysplasia (intestinal-type dysplasia in colitis-affected segments), serrated polyps in colitis-unaffected segments (usually proximal to the extent of the colitis), sporadic adenomas in colitis-unaffected segments, and invasive carcinoma. Additionally, serrated polyps in colitis-affected segments were histologically classified into three subtypes in accordance with previous studies [27 (link)–29 (link)], as follows: SSL-like dysplasia, TSA-like dysplasia, and serrated SD NOS. Briefly, SSL-like dysplasia is characterized by distorted serrated crypts with prominent basal crypt dilatation (i.e., dilated L- or inverted T-shaped crypts) at the interface with the muscularis mucosa. TSA-like dysplasia is characterized by a villiform growth pattern with columnar cells with intensely eosinophilic cytoplasm and ectopic crypts, creating a prominent serrated profile. SD NOS was defined as serrated dysplasia without definite features of SSL-like or TSA-like dysplasia, with a complex serrated architecture and evidence of dysplasia [27 (link)–29 (link)]. The representative endoscopic and histological features of SSL-like dysplasia, TSA-like dysplasia, and SD NOS are shown in
Histological Classification of Neoplasia in UC
We classified neoplasia into five categories on the basis of the histological findings and whether the neoplasia was located in colitis-affected segments, as follows: serrated polyps in colitis-affected segments, conventional dysplasia (intestinal-type dysplasia in colitis-affected segments), serrated polyps in colitis-unaffected segments (usually proximal to the extent of the colitis), sporadic adenomas in colitis-unaffected segments, and invasive carcinoma. Additionally, serrated polyps in colitis-affected segments were histologically classified into three subtypes in accordance with previous studies [27 (link)–29 (link)], as follows: SSL-like dysplasia, TSA-like dysplasia, and serrated SD NOS. Briefly, SSL-like dysplasia is characterized by distorted serrated crypts with prominent basal crypt dilatation (i.e., dilated L- or inverted T-shaped crypts) at the interface with the muscularis mucosa. TSA-like dysplasia is characterized by a villiform growth pattern with columnar cells with intensely eosinophilic cytoplasm and ectopic crypts, creating a prominent serrated profile. SD NOS was defined as serrated dysplasia without definite features of SSL-like or TSA-like dysplasia, with a complex serrated architecture and evidence of dysplasia [27 (link)–29 (link)]. The representative endoscopic and histological features of SSL-like dysplasia, TSA-like dysplasia, and SD NOS are shown in
Corresponding Organization : Yokohama City University
Other organizations : Niigata University, Chiba University
Variable analysis
- Location of neoplasia (colitis-affected segments, colitis-unaffected segments)
- Histological classification of neoplasia (serrated polyps, conventional dysplasia, serrated polyps in colitis-unaffected segments, sporadic adenomas in colitis-unaffected segments, invasive carcinoma)
- Subtypes of serrated polyps in colitis-affected segments (SSL-like dysplasia, TSA-like dysplasia, serrated SD NOS)
- Classification of neoplasia into the specified categories
- Expert gastrointestinal pathologists (YA and SC) who reviewed and classified the pathological slides
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