BACKGROUND: Accurate measures of the total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video. OBJECTIVE: To develop global quantitative tools of the FAP colorectal adenoma burden. DESIGN: A single-arm, phase II trial. PATIENTS: Twenty-seven patients with FAP. INTERVENTION: Treatment with celecoxib for 6 months, with before-treatment and after-treatment videos posted to an intranet with an interactive site for scoring. MAIN OUTCOME MEASUREMENTS: Global adenoma counts and sizes (grouped into categories: <2 mm, 2-4 mm, and >4 mm) were scored from videos by using a novel Web-based tool. Baseline and end-of-study adenoma burden results were summarized by using 5 models. Correlations between pairs of reviewers were analyzed for each model. RESULTS: Interobserver agreement was high for all 5 measures of polyp burden. Measures that used both polyp count and polyp size had better interobserver agreement than measures based only on polyp count. The measure in which polyp counts were weighted according to diameter, calculated as (1) × (no. of polyps <2 mm) + (3) × (no. of polyps 2-4 mm) + (5) × (no. of polyps >4 mm) had the highest interobserver agreement (Pearson r = 0.978 for two gastroenterologists, 0.786 and 0.846 for the surgeon vs each gastroenterologist). Treatment reduced the polyp burden by these measurements in 70% to 89% of patients (P < .001). LIMITATIONS: Phase II study. CONCLUSION: This novel, Web-based polyp scoring method provides a convenient and reproducible way to quantify the global colorectal adenoma burden in FAP patients and a framework for developing a clinical staging system for FAP.
BACKGROUND: Accurate measures of the total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video. OBJECTIVE: To develop global quantitative tools of the FAP colorectal adenoma burden. DESIGN: A single-arm, phase II trial. PATIENTS: Twenty-seven patients with FAP. INTERVENTION: Treatment with celecoxib for 6 months, with before-treatment and after-treatment videos posted to an intranet with an interactive site for scoring. MAIN OUTCOME MEASUREMENTS: Global adenoma counts and sizes (grouped into categories: <2 mm, 2-4 mm, and >4 mm) were scored from videos by using a novel Web-based tool. Baseline and end-of-study adenoma burden results were summarized by using 5 models. Correlations between pairs of reviewers were analyzed for each model. RESULTS: Interobserver agreement was high for all 5 measures of polyp burden. Measures that used both polyp count and polyp size had better interobserver agreement than measures based only on polyp count. The measure in which polyp counts were weighted according to diameter, calculated as (1) × (no. of polyps <2 mm) + (3) × (no. of polyps 2-4 mm) + (5) × (no. of polyps >4 mm) had the highest interobserver agreement (Pearson r = 0.978 for two gastroenterologists, 0.786 and 0.846 for the surgeon vs each gastroenterologist). Treatment reduced the polyp burden by these measurements in 70% to 89% of patients (P < .001). LIMITATIONS: Phase II study. CONCLUSION: This novel, Web-based polyp scoring method provides a convenient and reproducible way to quantify the global colorectal adenoma burden in FAPpatients and a framework for developing a clinical staging system for FAP.
Authors: Nicholas J West; Susan K Clark; Robin K S Phillips; John M Hutchinson; Roger J Leicester; Andrea Belluzzi; Mark A Hull Journal: Gut Date: 2010-03-26 Impact factor: 23.059
Authors: G Steinbach; P M Lynch; R K Phillips; M H Wallace; E Hawk; G B Gordon; N Wakabayashi; B Saunders; Y Shen; T Fujimura; L K Su; B Levin; L Godio; S Patterson; M A Rodriguez-Bigas; S L Jester; K L King; M Schumacher; J Abbruzzese; R N DuBois; W N Hittelman; S Zimmerman; J W Sherman; G Kelloff Journal: N Engl J Med Date: 2000-06-29 Impact factor: 91.245
Authors: Patrick M Lynch; Jeffrey S Morris; Sijin Wen; Shailesh M Advani; William Ross; George J Chang; Miguel Rodriguez-Bigas; Gottumukkala S Raju; Luigi Ricciardiello; Takeo Iwama; Benedito M Rossi; Maria Pellise; Elena Stoffel; Paul E Wise; Lucio Bertario; Brian Saunders; Randall Burt; Andrea Belluzzi; Dennis Ahnen; Nagahide Matsubara; Steffen Bülow; Niels Jespersen; Susan K Clark; Steven H Erdman; Arnold J Markowitz; Inge Bernstein; Niels De Haas; Sapna Syngal; Gabriela Moeslein Journal: Gastrointest Endosc Date: 2016-01-06 Impact factor: 9.427