Rapid Communication
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 28, 2008; 14(12): 1903-1907
Published online Mar 28, 2008. doi: 10.3748/wjg.14.1903
Importance of the surrounding colonic mucosa in distinguishing between hyperplastic and adenomatous polyps during acetic acid chromoendoscopy
Jeong Hwan Kim, Sun-Young Lee, Byung Kook Kim, Won Hyeok Choe, So Young Kwon, In-Kyung Sung, Hyung-Seok Park, Choon-Jo Jin
Jeong Hwan Kim, Sun-Young Lee, Byung Kook Kim, Won Hyeok Choe, So Young Kwon, In-Kyung Sung, Hyung-Seok Park, Choon-Jo Jin, Department of Internal Medicine, Konkuk University School of Medicine, Seoul 143-729, Korea
Correspondence to: Sun-Young Lee, MD, PhD, Department of Internal Medicine, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea. sunyoung@kuh.ac.kr
Telephone: +82-2-20307747
Fax: +82-2-20307748
Received: August 26, 2007
Revised: February 3, 2008
Published online: March 28, 2008
Abstract

AIM: To examine the characteristics of colonic polyps, where it is difficult to distinguish adenomatous polyps from hyperplastic polyps, with the aid of acetic acid chromoendoscopy.

METHODS: Acetic acid spray was applied to colonic polyps smaller than 10 mm before complete excision. Endoscopic images were taken before and 15-30 s after the acetic acid spray. Both pre- and post-sprayed images were shown to 16 examiners, who were asked to interpret the lesions as either hyperplastic or adenomatous polyps. Regression analysis was performed to determine which factors were most likely related to diagnostic accuracy.

RESULTS: In 50 cases tested by the 16 examiners, the overall accuracy was 62.4% (499/800). Regression analysis demonstrated that surrounding colonic mucosa was the only factor that was significantly related to accuracy in discriminating adenomatous from hyperplastic polyps (P < 0.001). Accuracy was higher for polyps with linear surrounding colonic mucosa than for those with nodular surrounding colonic mucosa (P < 0.001), but was not related to the shape, location, or size of the polyp.

CONCLUSION: The accuracy of predicting histology is significantly related to the pattern of colonic mucosa surrounding the polyp. Making a histological diagnosis of colon polyps merely by acetic acid spray is helpful for colon polyps with linear, regularly patterned surrounding colonic mucosa, and less so for those with nodular, irregularly patterned surrounding colonic mucosa.

Keywords: Colon polyp; Chromoendoscopy; Acetic acid