Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan

Background/Aims Endoscopists occasionally encounter discrepancies between endoscopic and pathological diagnoses after colorectal polypectomies. This study aimed to evaluate the efficacy of additional sections for diagnostic discrepancies. Methods We examined polyps endoscopically diagnosed as adenom...

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Main Authors: Tsuyoshi Ishii, Toshihiro Nishizawa, Hidenobu Watanabe, Masaya Sano, Ai Fujimoto, Yoshiyuki Takahashi, Ryo Shimizu, Hirotoshi Ebinuma, Takahisa Matsuda, Osamu Toyoshima
Format: Article
Language:English
Published: Korean Society of Gastrointestinal Endoscopy 2025-07-01
Series:Clinical Endoscopy
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Online Access:http://e-ce.org/upload/pdf/ce-2024-265.pdf
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author Tsuyoshi Ishii
Toshihiro Nishizawa
Hidenobu Watanabe
Masaya Sano
Ai Fujimoto
Yoshiyuki Takahashi
Ryo Shimizu
Hirotoshi Ebinuma
Takahisa Matsuda
Osamu Toyoshima
author_facet Tsuyoshi Ishii
Toshihiro Nishizawa
Hidenobu Watanabe
Masaya Sano
Ai Fujimoto
Yoshiyuki Takahashi
Ryo Shimizu
Hirotoshi Ebinuma
Takahisa Matsuda
Osamu Toyoshima
author_sort Tsuyoshi Ishii
collection DOAJ
description Background/Aims Endoscopists occasionally encounter discrepancies between endoscopic and pathological diagnoses after colorectal polypectomies. This study aimed to evaluate the efficacy of additional sections for diagnostic discrepancies. Methods We examined polyps endoscopically diagnosed as adenomas or suspected adenomas that were resected and pathologically diagnosed as adenomas or normal mucosa. Adenomas pathologically diagnosed with initial sections were categorized as the “adenoma by initial section” group. Based on the re-diagnosis with additional sectioning, they were assigned to the “adenoma by additional section” or “normal mucosa by both sections” groups. Results In the initial pathological diagnosis of 993 lesions, 850 were diagnosed as adenomas and 143 as normal mucosa. Additional sections corrected the pathological diagnoses in 23.8% (34/143) of cases. The rate of high confidence was significantly higher in the “adenoma by additional section” group than in the “normal mucosa by both sections” group (64.7% vs. 38.5%, p<0.01). Lesions in the “adenoma by additional section” group were significantly smaller than those in the “adenoma by initial section” group (2.7 vs. 3.8 mm, p<0.05). Conclusions Diminutive adenomas can cause discrepancies between endoscopic and pathological diagnoses. Additional sections may help revise the pathological diagnoses, particularly for lesions with high confidence.
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publishDate 2025-07-01
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spelling doaj-art-fe4c464ef40b466aae49042303d00aa42025-08-20T02:47:46ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-07-0158457758510.5946/ce.2024.2657994Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in JapanTsuyoshi Ishii0Toshihiro Nishizawa1Hidenobu Watanabe2Masaya Sano3Ai Fujimoto4Yoshiyuki Takahashi5Ryo Shimizu6Hirotoshi Ebinuma7Takahisa Matsuda8Osamu Toyoshima9 Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan Pathology and Cytology Laboratory Japan, Tokyo, Japan Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita, Japan Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Toho University, Tokyo, Japan Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, JapanBackground/Aims Endoscopists occasionally encounter discrepancies between endoscopic and pathological diagnoses after colorectal polypectomies. This study aimed to evaluate the efficacy of additional sections for diagnostic discrepancies. Methods We examined polyps endoscopically diagnosed as adenomas or suspected adenomas that were resected and pathologically diagnosed as adenomas or normal mucosa. Adenomas pathologically diagnosed with initial sections were categorized as the “adenoma by initial section” group. Based on the re-diagnosis with additional sectioning, they were assigned to the “adenoma by additional section” or “normal mucosa by both sections” groups. Results In the initial pathological diagnosis of 993 lesions, 850 were diagnosed as adenomas and 143 as normal mucosa. Additional sections corrected the pathological diagnoses in 23.8% (34/143) of cases. The rate of high confidence was significantly higher in the “adenoma by additional section” group than in the “normal mucosa by both sections” group (64.7% vs. 38.5%, p<0.01). Lesions in the “adenoma by additional section” group were significantly smaller than those in the “adenoma by initial section” group (2.7 vs. 3.8 mm, p<0.05). Conclusions Diminutive adenomas can cause discrepancies between endoscopic and pathological diagnoses. Additional sections may help revise the pathological diagnoses, particularly for lesions with high confidence.http://e-ce.org/upload/pdf/ce-2024-265.pdfdiagnosisendoscopymicrotomypathology
spellingShingle Tsuyoshi Ishii
Toshihiro Nishizawa
Hidenobu Watanabe
Masaya Sano
Ai Fujimoto
Yoshiyuki Takahashi
Ryo Shimizu
Hirotoshi Ebinuma
Takahisa Matsuda
Osamu Toyoshima
Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
Clinical Endoscopy
diagnosis
endoscopy
microtomy
pathology
title Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
title_full Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
title_fullStr Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
title_full_unstemmed Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
title_short Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
title_sort efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa a retrospective cross sectional study in japan
topic diagnosis
endoscopy
microtomy
pathology
url http://e-ce.org/upload/pdf/ce-2024-265.pdf
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