{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:40:22Z","timestamp":1790948422218,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Superficially serrated adenoma (SuSA) is a recently proposed subtype of colorectal serrated lesions. It is characterized by distinct clinicopathological and molecular features, including mixed serrated and adenomatous histology and frequent genetic alterations involving <jats:italic>KRAS<\/jats:italic> and <jats:italic>RSPO<\/jats:italic>. This study aimed to characterize the endoscopic features of isolated and traditional serrated adenoma (TSA)\u2010associated SuSAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated the endoscopic findings of 25 isolated SuSAs and 21 TSA\u2010associated SuSAs that were histologically and molecularly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SuSAs appeared as a sessile polyp or slightly elevated lesion located mostly in the sigmoid colon and rectum (88%). The size was between 3 and 20\u2009mm (median, 6\u2009mm). Most of them exhibited <jats:italic>KRAS<\/jats:italic> mutations (96%) and <jats:italic>RSPO<\/jats:italic> fusions\/overexpression (92%). Endoscopically, many lesions had a whitish color (84%), a distinct border (96%), an irregular border (76%), and a lobulated surface (72%). However, diminutive lesions exhibited overlapping features with hyperplastic polyps. On narrow\u2010band imaging, vessel patterns were invisible or appeared as lacy microvessels in most lesions (80%). Chromoendoscopy invariably showed stellar or elongated\/branched stellar pits, indicating a serrated microarchitecture. Most TSA\u2010associated SuSAs typically presented as polyps with a two\u2010tier raised appearance, consisting of whitish lower and reddish higher components corresponding to a SuSA and a TSA, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SuSAs exhibit several characteristic endoscopic features on white\u2010light and image\u2010enhanced endoscopy. Diminutive lesions exhibit endoscopic features overlapping with hyperplastic polyps. Nonetheless, the endoscopic diagnosis of larger and TSA\u2010associated SuSAs may be feasible.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.13992","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T20:02:36Z","timestamp":1618862556000},"page":"153-162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Endoscopic features of isolated and traditional serrated adenoma\u2010associated superficially serrated adenomas of the colorectum"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-0692","authenticated-orcid":false,"given":"Yasuhiko","family":"Mizuguchi","sequence":"first","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"},{"name":"Division of Diagnostic Pathology National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusaku","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"},{"name":"Division of Gastroenterology Keiyu Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1260-8692","authenticated-orcid":false,"given":"Hourin","family":"Cho","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6253-6896","authenticated-orcid":false,"given":"Masau","family":"Sekiguchi","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"},{"name":"Cancer Screening Center National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7019-6331","authenticated-orcid":false,"given":"Hiroyuki","family":"Takamaru","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-5560","authenticated-orcid":false,"given":"Masayoshi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0239-4977","authenticated-orcid":false,"given":"Taku","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9244-2820","authenticated-orcid":false,"given":"Takahisa","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"},{"name":"Cancer Screening Center National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3148-9243","authenticated-orcid":false,"given":"Taiki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Sekine","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology National Cancer Center Hospital Tokyo Japan"},{"name":"Division of Molecular Pathology National Cancer Center Research Institute Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9574-7451","authenticated-orcid":false,"given":"Yutaka","family":"Saito","sequence":"additional","affiliation":[{"name":"Endoscopy Division National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"163","volume-title":"Disgetive system tumours","author":"Pai RK","year":"2019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.05.006"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.08.008"},{"key":"e_1_2_8_5_1","first-page":"45","article-title":"Endoscopic features of sessile serrated adenoma and other serrated colorectal polyps","volume":"58","author":"Yamada A","year":"2011","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2012.12.018"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.457"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.12.037"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-014-0999-y"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13263"},{"key":"e_1_2_8_11_1","first-page":"785","article-title":"Endoscopic discrimination of sessile serrated adenomas from other serrated lesions","volume":"2","author":"Hasegawa S","year":"2011","journal-title":"Oncol Lett"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2015.04.002"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0069-8"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4709"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-019-02604-x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-020-01673-z"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13867"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.23922\/jarc.2019-018"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13065"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(96)70222-5"},{"key":"e_1_2_8_21_1","first-page":"1653","article-title":"The correspondency of magnifying endoscopic diagnosis and pathological diagnosis: Case of colon epithelial tumor","volume":"34","author":"Fujii T","year":"1999","journal-title":"Stom Intest"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2005.00483.x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13265"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2010.075507"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000103"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1443-1661.14.s1.7.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000253"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPDJC9VC5KTYUS"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-020-01697-5"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-018-5016-5"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13603"}],"container-title":["Digestive Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.13992","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/den.13992","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.13992","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T21:51:21Z","timestamp":1693000281000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/den.13992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,24]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/den.13992"],"URL":"https:\/\/doi.org\/10.1111\/den.13992","archive":["Portico"],"relation":{},"ISSN":["0915-5635","1443-1661"],"issn-type":[{"value":"0915-5635","type":"print"},{"value":"1443-1661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,24]]},"assertion":[{"value":"2020-09-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}