Colonic polyps: Is it useful to characterize them with advanced endoscopy?

Table 1 Pit pattern classification

Kudo et al[8] class	Description	Most likely histology	Neoplastic/non-neoplastic	Treatment
I	Round crypts	Normal mucosa	Non-neoplastic	None
II	Regular wider or stellar crypts	Hyperplastic polyp (also sessile serrated adenomas)	Non-neoplastic	None if rectosigmoid and ≤ 5 mm/endoscopic resection
IIIL	Elongated or roundish crypts	Adenoma	Neoplastic	Endoscopic resection
IIIs	Tubular or roundish pits smaller than the normal crypts	Intramucosal/superficial invasive cancer	Neoplastic	Endoscopic resection
IV	Branch-like or gyrus-like crypts	Adenoma	Neoplastic	Endoscopic resection
Vi	Irregular crypts	Superficial invasive/deep invasive cancer	Neoplastic	Surgery/endoscopic resection in selected cases
Vn	Non-structural crypts	Deep submucosal invasive cancer	Neoplastic	Surgery

Table 2 Capillary pattern classification determined from narrow band imaging with magnification

	Sano et al[29] classification
	CPI	CPII	CPIIIA	CPIIIB
Capillary pattern	Absent	Present	Present
			Meshed capillary vessels with blind endings, branching and curtailed irregularity
Capillary characteristics	-	Vessels surrounding glands	Lack of uniformity, high density of vessels	Nearly avascular or loose microvessels
Most likely histology	Normal or hyperplastic polyp	Adenoma or intramucosal carcinoma	Superficial submucosal invasive carcinoma (sm1)	Deep submucosal invasive carcinoma
Treatment	None	Polypectomy or endoscopic mucosal resection	Polypectomy or endoscopic mucosal resection/surgery	Surgery

Table 3 Narrow band imaging-international colorectal endoscopic classification as determined by narrow band imaging with/without magnification

	Type 1	Type 2	Type 3
Color	Same or lighter than background	Brown	Brown or dark brown Occasional white patchy areas
Vessels	None or isolated lacy vessels	Brown vessels surrounding white structures	Areas of disrupted or missing vessels
Surface pattern	Dark or white spots of uniform size or homogeneous absence of pattern	Oval, tubular or branched white structures surrounded by brown vessels	Amorphous or absent surface pattern
Most likely histology	Hyperplastic polyp	Adenoma or intramucosal or superficial submucosal invasive carcinoma (sm1)	Deep submucosal invasive carcinoma
Treatment	None	Polypectomy or endoscopic mucosal resection	Surgery