Open AccessEpidemiological, clinical and endoscopic characteristics of colorectal neuroendocrine neoplasms: a population-based study in the Netherlands
Author(s) -
Ankie Reumkens,
Prapto Sastrowijoto,
Heike Grabsch,
Danny Goudkade,
Chantal M. le Clercq,
C. M. Bakker,
Eric T.P. Keulen,
Rogier de Ridder,
Wouter W. de Herder,
Björn Winkens,
Silvia Sanduleanu,
Judith de VosGeelen,
Ad Masclee
Publication year - 2022
Publication title -
endoscopy international open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
0eISSN - 2364-3722
pISSN - 2196-9736
DOI - 10.1055/a-1793-9057
Subject(s) - medicine , incidence (geometry) , colonoscopy , epidemiology , population , rectum , lipoma , neuroendocrine tumors , colorectal cancer , cohort , gastrointestinal pathology , endoscopy , gastroenterology , pathology , cancer , physics , environmental health , optics
Background and study aims: Neuroendocrine neoplasms (NEN) account for a small number of colorectal neoplasms. Endoscopic detection is essential for diagnosis, treatment and follow-up. Little is known about incidence of NENs in colonoscopy populations, and relationship between clinical, endoscopic and histopathology features. We evaluated epidemiology, endoscopic and clinical characteristics of colorectal NENs in a population-based cohort. Patients and methods: Medical records of NEN cases were cross-linked with the national pathology database from January 2001 to December 2015, in the South Limburg county, the Netherlands, covering four endoscopy units. Senior pathologists reviewed and classified NENs using WHO 5th edition (2019) guidelines.Results: The number of colorectal NEN diagnoses was stable over time with 0.6 NEN per 1,000 colonoscopies. A total of 85 patients with NEN were detected: 65 neuroendocrine tumors (NETs) and 20 poorly differentiated neuroendocrine carcinomas (NECs). Rectal NETs were usually small sessile/submucosal lesions with yellowish (lipoma-like) colour. Colonic NETs were larger sessile/submucosal lesions with darker colour compared to background. Colorectal NECs presented as large, dark coloured lesions with ulcerated/necrotizing areas. Conclusions: Our population-based data point to a stable and low incidence of 0.6 NEN per 1,000 colonoscopies in the Netherlands. Rectal NETs mainly present as small sessile yellowish lesions. Colonic NETs present as larger and darker lesions than background mucosa and NECs as darker lesions than background with ulceration/ necrosis. Standardized endoscopic characterization of colorectal NENs is necessary to improve recognition of these lesions and provide a basis for evidence-based treatment and surveillance recommendations.