Prospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2018; 10(4): 96-102
Published online Apr 15, 2018. doi: 10.4251/wjgo.v10.i4.96
Prospective real-time evaluation of diagnostic performance using endocytoscopy in differentiating neoplasia from non-neoplasia for colorectal diminutive polyps (≤ 5 mm)
Takahiro Utsumi, Yasushi Sano, Mineo Iwatate, Hironori Sunakawa, Akira Teramoto, Daizen Hirata, Santa Hattori, Wataru Sano, Noriaki Hasuike, Kazuhito Ichikawa, Takahiro Fujimori
Takahiro Utsumi, Yasushi Sano, Mineo Iwatate, Hironori Sunakawa, Akira Teramoto, Daizen Hirata, Santa Hattori, Wataru Sano, Noriaki Hasuike, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo 655-0031, Japan
Kazuhito Ichikawa, Takahiro Fujimori, Department of Pathology, Shinko Hospital, Hyogo 651-0072, Japan
Author contributions: Utsumi T, Sano Y, Iwatate M, Sunakawa H, Teramoto A, Hirata D, Sano W, Hasuike N, Ichikawa K and Fujimori T designed the study; Utsumi T collected the data; Utsumi T, Sano Y and Iwatate M drafted the study, analyzed the data and wrote the manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board at Sano Hospital.
Informed consent statement: Written informed consent for the procedures was obtained from all patients.
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yasushi Sano, MD, PhD, Doctor, Professor, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, 2-5-1 Shimizugaoka, Tarumi-ku, Hyogo 655-0031, Japan. ys_endoscopy@hotmail.com
Telephone: +81-78-7851000 Fax: +81-78-7850077
Received: December 17, 2017
Peer-review started: December 17, 2017
First decision: January 6, 2018
Revised: January 10, 2018
Accepted: March 6, 2018
Article in press: March 6, 2018
Published online: April 15, 2018
ARTICLE HIGHLIGHTS
Research background

Endocytoscopy, which will be newly launched in 2018, allows us to observe both structural and cellular atypia in vivo. The Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) document described key thresholds for assessing the histology of diminutive polyps (≤ 5 mm) using endoscopic technology. However, few studies about endocytoscopy have examined its diagnostic performance for diminutive colorectal polyps.

Research motivation

This study before the launch of endocytoscopy can help to understand the usefulness of endocytoscopy.

Research objectives

To clarify the diagnostic performance of endocytoscopy for differentiating neoplastic from non-neoplastic diminutive colorectal polyps.

Research methods

We prospectively recruited patients who underwent endocytoscopy between October and December 2016 at Sano Hospital. Diminutive polyps were evaluated by endocytoscopy after being stained with 0.05% crystal violet and 1% methylene blue. The diminutive polyps were classified according to the endocytoscopic (EC) classification. Endoscopists have assessed the diagnostic performance of endocytoscopy for EC2 (indicator of adenoma) and EC1b (indicator of hyperplastic polyp) lesions by comparison with the histopathology of the biopsy specimen.

Research results

A total of 39 patients with 63 diminutive polyps were analyzed. The accuracy and negative predictive value of EC2 for adenoma compared with EC1b for hyperplastic polyp were 98.0% and 92.3%. Endocytoscopy showed a high diagnostic performance for differentiating between neoplastic and non-neoplastic colorectal diminutive polyps. However, because endocytoscope was available to our institute for only a limited period, the number of samples was small.

Research conclusions

The diagnostic performance of endocytoscopy for colorectal diminutive polyps met the PIVI criteria for assessment of histology.

Research perspectives

Real-time histopathologic assessment by endocytoscopy has the potential to save histopathological diagnosis. Additional multicenter studies are needed to confirm our result.