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EFFICACY OF MAGNIFYING COLONOSCOPY FOR THE DIAGNOSIS OF COLORECTAL NEOPLASIA: COMPARISON WITH HISTOPATHOLOGICAL FINDINGS
Author(s) -
Ohta Akihiko,
Tominaga Kenji,
Sakai Yoshihiro
Publication year - 2004
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/j.1443-1661.2004.00407.x
Subject(s) - medicine , atypia , colonoscopy , crypt , pathology , histopathological examination , colorectal cancer , radiology , gastroenterology , cancer
Background: Some authors have reported a good correlation between the shape and arrangement in the orice of mucosal crypt (pit pattern) in the diagnosis of colorectal lesions and histopathological ndings. However, there remains no good consensus on the denition of irregularity in congurations. Methods: We studied 110 colorectal neoplasia of 110 cases that were examined using a magnifying colonoscope and resected endoscopically or surgically between 2001 and 2003. We divided the lesions into two groups according to Fujii's classication as follows: type Non‐V showed type III or IV by Kudo's classication and irregular pits not occurring in a demarcated area; and type V showed irregular pits, which occurred in a demarcated area in addition to type V N by Kudo. The diagnosis by this classication correlated with the histopathological ndings. We also addressed the causes of misdiagnosis in comparison with histopathological ndings. Results: The diagnostic accuracy for Non‐V and V was 95.1% and 82.1%, respectively. Lesions classied as V showed a signicant correlation. Histologically, carcinoma consisted of high‐grade atypia ( P < 0.0001), an erosive change of surface epithelium ( P < 0.0001) and the appearance of desmoplastic reactions ( P = 0.002) in comparison with Non‐V. Misdiagnosis was likely due to differences in the grade of atypia between supercial and deeper glands and explainable erosive changes on the surface, as well as simple misreading of the pit pattern. Conclusion: Diagnosis of colorectal neoplasia by magnifying colonoscope using our classication was useful for evaluating the depth of invasion and correlated well with histopathological ndings.