Published by Elsevier Science Inc. PII S0002 （PII发表由爱思唯尔科学公司。S0002）.pdf

THE AMERICAN JOURNAL OF GASTROENTEROLOGY Vol. 95, No. 11, 2000 © 2000 by Am. Coll. of Gastroenterology ISSN 0002-9270/00/$20.00 Published by Elsevier Science Inc. PII S0002-9270(00)02227-9 PRACTICE GUIDELINES Polyp Guideline: Diagnosis, Treatment, and Surveillance for Patients With Colorectal Polyps* John H. Bond, M.D., for the Practice Parameters Committee of the American College of Gastroenterology Gastroenterology Section, Minneapolis Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota PREAMBLE DEFINITION AND CLINICAL CONSIDERATIONS This guideline is a revision of a guideline originally devel- Colorectal polyps are classified histologically as neoplastic oped and published in 1993 (1). It is intended to indicate or nonneoplastic. Most colorectal cancers arise from neo- preferable approaches to the management of patients with plastic adenomatous polyps (adenomas). Adenomas are colorectal polyps based on available scientific evidence. It monoclonal derivatives of a mutated epithelial stem cell. does not deal with colorectal neoplasia screening, a topic Simple small (1 cm) tubular adenomas are extremely that has been addressed in three recent evidence-based common and have a low risk of becoming malignant. Only guidelines (2–4). It also does not deal with patients with a few acquire the additional genetic alterations that make known colon cancer, hereditary nonpolyposis colorectal them grow, develop advanced histological