Hyperplastic-like Polyps as Precursors of Microsatellite-Unstable Colorectal Cancer
Bibliographic record
Abstract
The study reported by Goldstein et al 1 in this issue of the Journal presents a detailed survey of the morphologic heterogeneity that may be encountered in hyperplastic polyps of the colorectum.Two groups of hyperplastic polyps were compared.The study group comprised 106 colonoscopically obtained hyperplastic polyps from the proximal colon from a series of 91 patients who subsequently had sporadic DNA microsatellite instability-high (MSI-H) cancer in the same anatomic region.The control group comprised 106 hyperplastic polyps from the sigmoid colon or rectum from subjects in whom neoplasia of any type did not develop subsequently.The 2 groups of hyperplastic polyps differed in terms of multiple architectural, cytologic, maturational, and proliferative indices.The existence of morphologic, functional, and genetic heterogeneity within hyperplastic polyps has been known for some time.In 1984, a subset of hyperplastic polyps was reported to show loss of O-acetyl sialic acid, a functional alteration that also characterizes colorectal cancer and dysplasia in ulcerative colitis. 2 The hyperplastic polyps with the mucin alteration were larger, showed more papillarity, were lined by taller cells, had more nuclear alterations, had more mitoses, showed more mucin production, and had more expression of carcinoembryonic antigen than hyperplastic polyps that lacked the sialic acid alteration.Anatomic site differences were not explored, and the authors concluded that the 2 groups of hyperplastic polyps probably were part of a biologic continuum rather than representing distinct and separate entities.In 1996, Torlakovic and Snover 3 published a careful appraisal of hyperplastic polyps occurring in the context of hyperplastic polyposis.They concluded that these polyps
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.003 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.005 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".