Skip to main content
Log in

Endocytoscopic classification of preneoplastic lesions in the colorectum

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to assess the capability of endocytoscopy (ECS) in differentiating neoplastic from nonneoplastic lesions in the colorectum and to validate an ECS classification.

Methods

Patients with colorectal polypoid and nonpolypoid lesions ≤10 mm were prospectively included. ECS classification subgrouped nonneoplastic (EC 0) and neoplastic (EC 1–3) lesions. Lesions were observed at super-magnified view (450×) before endoscopic resection. Blinded pathological assessment was obtained.

Results

Fifty-two lesions were examined in 49 patients (17 polypoid and 35 nonpolypoid). Final pathological diagnosis was normal mucosa or hyperplastic polyp in ten cases, low-grade adenoma in 29, high-grade adenoma in 11, and submucosal invasive cancer in two cases. Positive predictive values of each EC group were 100%, 93.1%, 90.1%, and 100%, respectively. ECS diagnosis correlated completely with pathology in the differentiation between neoplastic and nonneoplastic lesions.

Conclusions

ECS enabled observation of colorectal lesion at a subcellular level in vivo. The classification of ECS images had a good correlation with the final pathological diagnosis. ECS was useful to differentiate between neoplastic and nonneoplastic lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Inoue H, Kudo SE, Shiokawa A (2005) Laser-scanning confocal microscopy and endocytoscopy for cellular observation of the gastrointestinal tract. Nat Clin Pract Gastroenterol Hepatol 2:31–37

    Article  PubMed  Google Scholar 

  2. American Society for Gastrointestinal Endoscopy Report on Emerging Technology (2009) Endocytoscopy. Gastrointest Endosc 70:610–613

    Article  Google Scholar 

  3. Eberl T, Jechart G, Probst A et al (2007) Can an endocytoscope system predict histology in neoplastic lesions? Endoscopy 39:497–501

    Article  CAS  PubMed  Google Scholar 

  4. Cipolletta L, Bianco MA, Rotondano G et al (2009) Endocytoscopy can identify dysplasia in aberrant crypt foci of the colorectum: a prospective in vivo study. Endoscopy 41:129–132

    Article  CAS  PubMed  Google Scholar 

  5. Sasajima K, Kudo SE, Inoue H et al (2006) Real-time in vivo virtual histology of colorectal lesions when using the endocytoscopy system. Gastrointest Endosc 63:1010–1017

    Article  PubMed  Google Scholar 

  6. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon (2003) Gastrointest Endosc 58 (6 Suppl):S3–S43

    Google Scholar 

  7. Kodashima S, Fujishiro M, Takubo K et al (2006) Ex-vivo study of high-magnification chromoendoscopy in the gastrointestinal tract to determine the optimal staining conditions for endocytoscopy. Endoscopy 38:1115–1121

    Article  CAS  PubMed  Google Scholar 

  8. Dixon MF (2002) Gastrointestinal epithelial neoplasia: Vienna revisited. Gut 51:130–131

    Article  CAS  PubMed  Google Scholar 

  9. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    CAS  PubMed  Google Scholar 

  10. Kudo S, Rubio CA, Teixeira CR et al (2001) Pit pattern in colorectal neoplasia: endoscopic magnifying view. Endoscopy 33:367–373

    CAS  PubMed  Google Scholar 

  11. Fu KI, Sano Y, Kato S et al (2004) Chromoendoscopy using indigo carmine dye spraying with magnifying observation is the most reliable method for differential diagnosis between non-neoplastic and neoplastic colorectal lesions: a prospective study. Endoscopy 36:1089–1093

    Article  PubMed  Google Scholar 

  12. Zanoni EC, Cutait R, Averbach M et al (2007) Magnifying colonoscopy: interobserver agreement in the assessment of colonic pit patterns and its correlation with histopathological findings. Int J Colorectal Dis 22:1383–1388

    Article  PubMed  Google Scholar 

  13. Bianco MA, Rotondano G, Marmo R et al (2006) Predictive value of magnification chromoendoscopy for diagnosing invasive neoplasia in nonpolypoid colorectal lesions and stratifying patients for endoscopic resection or surgery. Endoscopy 38:470–476

    Article  CAS  PubMed  Google Scholar 

  14. Chang CC, Hsieh CR, Lou HY et al (2009) Comparative study of conventional colonoscopy, magnifying chromoendoscopy, and magnifying narrow-band imaging systems in the differential diagnosis of small colonic polyps between trainee and experienced endoscopist. Int J Colorectal Dis 24:1413–1419

    Article  PubMed  Google Scholar 

  15. Li X, Chen H, Gao Y, Ge Z et al (2010) Prediction of histology and invasive depth of colorectal neoplasia based on morphology of surface depression using magnifying chromocolonoscopy. Int J Colorectal Dis 25:79–85

    Article  PubMed  Google Scholar 

  16. Seitz U, Seewald S, Bohnacker S, Soehendra N (2003) Advances in interventional gastrointestinal endoscopy in colon and rectum. Int J Colorectal Dis 18:12–18

    Article  PubMed  Google Scholar 

  17. Cipolletta L, Bianco MA, Garofano ML et al (2010) A randomised study of hydro-jet vs. needle injection for lifting colorectal lesions prior to endoscopic resection. Dig Liver Dis 42:127–130

    Article  CAS  PubMed  Google Scholar 

  18. Hoffman A, Goetz M, Vieth M et al (2006) Confocal laser endomicroscopy: technical status and current indications. Endoscopy 38:1275–1283

    Article  CAS  PubMed  Google Scholar 

  19. Borschitz T, Kiesslich R (2010) Confocal chromolaser endomicroscopy: a supplemental diagnostic tool prior to transanal endoscopic microsurgery of rectal tumors? Int J Colorectal Dis 25:71–77

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gianluca Rotondano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rotondano, G., Bianco, M.A., Salerno, R. et al. Endocytoscopic classification of preneoplastic lesions in the colorectum. Int J Colorectal Dis 25, 1111–1116 (2010). https://doi.org/10.1007/s00384-010-0969-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-010-0969-7

Keywords

Navigation