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@ARTICLE{Zhan:127847,
      author       = {T. Zhan$^*$ and F. Hahn and T. Hielscher$^*$ and J.
                      Betge$^*$ and G. Kähler and M. P. Ebert and S. Belle},
      title        = {{F}requent co-occurrence of high-grade dysplasia in large
                      flat colonic polyps $(\>20$ mm) and synchronous polyps.},
      journal      = {BMC gastroenterology},
      volume       = {15},
      number       = {1},
      issn         = {1471-230X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2017-03869},
      pages        = {82},
      year         = {2015},
      abstract     = {Large colonic polyps are associated with advanced
                      dysplasia, but prevalence and characteristics of synchronous
                      polyps in patients with large flat colonic polyps are poorly
                      investigated. This study aims to characterize
                      clinicopathological features of large flat colonic polyps
                      and their impact on occurrence and characteristics of
                      synchronous polyps.A total of 802 patients that underwent
                      endoscopic mucosal resection (EMR) of flat colonic polyps
                      >20 mm from 2003 to 2014 in an academic endoscopy unit were
                      retrospectively analyzed for size, location and histology of
                      large polyps and synchronous polyps.Average size of large
                      polyps was 34.1 mm (range 20-150 mm, standard deviation 16.1
                      mm). Histology included 52.5 $\%$ adenomas with low-grade
                      dysplasia (LGD), 26.7 $\%$ with high-grade dysplasia (HGD),
                      9.6 $\%$ serrated polyps and 11.2 $\%$ adenocarcinomas. The
                      majority of large polyps were localized in the proximal
                      colon (61 $\%).$ 72.2 $\%$ of adenocarcinomas were found in
                      the distal colon, while 80.5 $\%$ of all serrated polyps
                      were detected in the proximal colon. Increase in polyp size,
                      advanced age and location in the distal colon were
                      associated with presence of HGD/adenocarcinoma in large
                      polyps, as identified by multivariate analysis. Synchronous
                      polyps were detected in 67.2 $\%$ of patients undergoing
                      complete colonoscopy during EMR. Presence of
                      HGD/adenocarcinoma in the large polyp, localization of any
                      synchronous polyp in the rectosigmoid colon and occurrence
                      of multiple synchronous polyps were associated with presence
                      of HGD/adenocarcinoma in synchronous polyps.Synchronous
                      polyps are frequently found in patients with large flat
                      colonic polyps. The prevalence of synchronous polyps with
                      high grade dysplasia is highest in patients with large flat
                      polyps containing HGD/adenocarcinoma.},
      cin          = {B110 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)B110-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {312 - Functional and structural genomics (POF3-312)},
      pid          = {G:(DE-HGF)POF3-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:26160557},
      pmc          = {pmc:PMC4498525},
      doi          = {10.1186/s12876-015-0312-4},
      url          = {https://inrepo02.dkfz.de/record/127847},
}