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World J Gastroenterol. Mar 7, 2006; 12(9): 1416-1420
Published online Mar 7, 2006. doi: 10.3748/wjg.v12.i9.1416
Magnifying colonoscopy as a non-biopsy technique for differential diagnosis of non-neoplastic and neoplastic lesions
Shigeharu Kato, Kuang I Fu, Yasushi Sano, Takahiro Fujii, Yutaka Saito, Takahisa Matsuda, Ikuro Koba, Shigeaki Yoshida, Takahiro Fujimori
Shigeharu Kato, Kuang I Fu, Yasushi Sano, Ikuro Koba, Shigeaki Yoshida, Division of Gastrointestinal Oncology and Digestive Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
Kuang I Fu, Takahiro Fujimori, Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, 880 Kitakobaysashi, Mibu, Shimotuga, Tochigi 321-0293, Japan
Takahiro Fujii, Yutaka Saito, Takahisa Matsuda, Division of Endoscopy, National Cancer Center Hospital, Tsukiji, Tokyo 104-0045, Japan
Correspondence to: Kuangi Fu, MD, Division of Gastrointestinal Oncology and Digestive Endoscopy, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan. fukuangi@hotmail.com
Telephone: +81-47-1331111 Fax: +81-47-1314724
Received: September 16, 2005
Revised: October 1, 2005
Accepted: October 26, 2005
Published online: March 7, 2006
Abstract

AIM: To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps.

METHODS: From June 1999 through March 2000, 180 consecutive patients with 210 lesions diagnosed with a magnifying colonoscope (CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan) were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation. Lesions showing types I and II crypt patterns were considered non-neoplastic and examined histologically by biopsy, whereas lesions showing types III to V crypt patterns were removed endoscopically or surgically. The correlation of endoscopic diagnosis and histologic diagnosis was then investigated.

RESULTS: At endoscopy, 24 lesions showed a type I or II pit pattern, and 186 lesions showed type III to V pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184 lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% (208/210). The sensitivity and specificity were 92.3% (24/26) and 99.8% (184/186), respectively.

CONCLUSION: Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.

Keywords: Non-biopsy technique; Magnifying colonoscopy; Indigo-carmine dye spraying; Pit Pattern