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Usefulness of confocal laser endomicroscopy to diagnose ulcerative colitis‐associated neoplasia
Author(s) -
Ohmiya Naoki,
Horiguchi Noriyuki,
Tahara Tomomitsu,
Yoshida Dai,
Yamada Hyuga,
Nagasaka Mitsuo,
Nakagawa Yoshihito,
Shibata Tomoyuki,
Tsukamoto Tetsuya,
Kuroda Makoto
Publication year - 2017
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12853
Subject(s) - medicine , ulcerative colitis , microscopic colitis , endomicroscopy , confocal , pathology , dermatology , inflammatory bowel disease , optics , disease , physics
Chromoendoscopy, narrow‐band imaging ( NBI ), and confocal laser endomicroscopy ( CLE ) have been introduced in ulcerative colitis ( UC )‐associated neoplasia surveillance. We aimed to determine the ability of CLE to differentiate among UC ‐associated neoplasia (differentiated type or undifferentiated type), sporadic adenoma, and circumscribed regenerative lesions. Of 665 patients with UC , we carried out probe‐based CLE ( pCLE ) on 12 patients with suspected UC ‐associated neoplasia in addition to magnifying chromoendoscopy with crystal violet and NBI . We compared pCLE findings with pathological diagnoses. pCLE could differentiate UC ‐associated differentiated cancer from other pathologies such as solitary adenoma and non‐neoplastic circumscribed regenerative lesions on the basis of back‐to‐back orientation of crypts ( P = 0.048), and UC ‐associated undifferentiated cancer from other pathologies on the basis of dark trabecular architecture ( P = 0.015). Sensitivity, specificity, and accuracy of combination of back‐to‐back orientation of crypts and dark trabecular architecture for carcinoma or dysplasia were 100%, 83%, and 92%, respectively. In vivo microscopic observation with pCLE was helpful to evaluate the suspected UC ‐associated neoplasia.