Abstract
Background and aims Preoperative estimation of depth of invasion in early colorectal cancers (CRCs) is essential for patient management. This study was conducted to compare the diagnostic accuracies of magnifying colonoscopy and endoscopic ultrasonography (EUS) for estimating the depth of invasion of early CRCs. Subjects and methods A total of 438 early CRCs were removed endoscopically or surgically from July 1993 through March 1999 at our hospital. Before removal, 102 lesions were evaluated with both magnifying colonoscopy and EUS and were included in this analysis. The diagnostic accuracy of each method, referring to the histology of the resected specimens, was evaluated. Results The overall diagnostic accuracies were 87% (89/102) for magnifying colonoscopy and 75% (76/102) for EUS (P = 0.0985). Subgroup analysis was also done for polypoid and non-polypoid lesions. For polypoid lesions, the overall diagnostic accuracies of magnifying colonoscopy and EUS were 88% (60/68) and 72% (49/68), (P = 0.0785), and for non-polypoid lesions, they were 85% (29/34) and 79% (27/34), (P = 0.7169). Conclusion Although, there is a substantial difference in the overall diagnostic accuracies, it is not statistically significant. Therefore, we conclude that magnifying colonoscopy is at least as accurate as EUS for preoperative staging of early CRCs.
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Greene FL, Page DL, Fleming ID, et al (2002) AJCC cancer staging handbook, 6th edn. Lippincott Raven, Philadelphia
Morson BC, Whiteway JE, Jones EA, et al (1984) Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy. Gut 25:437–444
Fujimori T, Kawamata H, Kashida H (2001) Precancerous lesion of the colorectum. J Gastroenterol 36:587–594
Kyzer S, Begin LR, Gordon PH, et al (1992) The care of patients with colorectal polyps that contain invasive adenocarcinoma. Cancer (Phila) 70:2044–2050
Minamoto T, Mai M, Ogino T, et al (1993) Early invasive colorectal carcinomas metastatic to the lymph node with attention to their nonpolypoid development. Am J Gastroenterol 88:1035–1039
Cooper HS (1983) Surgical pathology of endoscopically removed malignant polyps of the colon and rectum. Am J Surg Pathol 7:613–623
Nusko G, Mansmann U, Partzsch U, et al (1997) Invasive carcinoma in colorectal adenomas: multivariate analysis of patient and adenoma characteristics. Endoscopy 29:626–631
Nascimbeni R, Burgart LJ, Nivatvongs S, et al (2002) Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. Dis Colon Rectum 45:200–206
Coverlizza S, Risio M, Ferrari A, et al (1989) Colorectal adenomas containing invasive carcinoma: pathologic assessment of lymph node metastatic potential. Cancer (Phila) 64:1937–1947
Cranley JP, Petras RE, Carey WD, et al (1986) When is endoscopic polypectomy adequate therapy for colonic polyps containing invasive carcinoma? Gastroenterology 91:419–427
Nivatvongs S, Rojanasakul A, Reiman HM, et al (1991) The risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma. Dis Colon Rectum 34:323–328
Netzer P, Forster C, Biral R, et al (1998) Risk factor assessment of endoscopically removed malignant polyps. Gut 43:669–674
Davila RE, Rajan E, Adler D, et al (2005) ASGE guideline: the role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointest Endosc 61(1):1–7
Fujii T, Hasegawa RT, Saitoh Y, et al (2001) Chromoscopy during colonoscopy. Endoscopy 33:1036–1041
Japanese Research Society for Cancer of the Colon, Rectum (1983) General rules for clinical and pathological studies on cancer of the colon, rectum and anus. Jpn J Surg 13:557–573
Kudo S, Soga J, Shimoda S, et al (1984) Treatment of colorectal submucosal carcinoma. Stomach Intest 19:1349–1356 (in Japanese with English abstract)
Mochizuki H, Hase K, Yagyu T (1994) The significance of histopathologic findings in the submucosal invasive front of early colorectal carcinoma in terms of regional lymph node metastasis and tumor recurrence. Stomach Intest 29:1143–1150 (in Japanese with English abstract)
Kobayashi M, Watanabe H, Maeo S, et al (1994) Correlation of histological atypia and cancer-sprouting with vascular permeation and lymph nodal metastasis by our new histological classification of submucosal invasion by colorectal carcinomas. Stomach Intest 29:1151–1156 (in Japanese with English abstract)
Tanaka S, Haruma K, Teixeira C, et al (1995) Endoscopic treatment of submucosal invasive colorectal carcinoma with special reference to risk factor for lymph node metastasis. J Gatroenterol 30:710–717
Tsuruta O, Toyonaga A, Ikeda H, et al (1997) Clinicopathological study of superficial-type invasive carcinoma of the colorectum: special reference to lymph node metastasis. Int J Oncol 10:1003–1008
Matsumoto T, Hizawa K, Esaki M, et al (2002) Comparison of EUS and magnifying colonoscopy for assessment of small colorectal cancers. Gastrointest Endosc 56:354–360
Watanabe H, Miwa H, Terai T, et al (1997) Endoscopic ultrasonography for colorectal cancer using submucosal saline solution injection. Gastrointest Endosc 45:508–511
Yamashita Y, Machi J, Shirouzu K, et al (1988) Evaluation of endorectal ultrasound for the assessment of wall invasion of rectal cancer. Report of a case. Dis Colon Rectum 31:617–623
McClave SA, Jones WF, Woolfolk GM, et al (2000) Mistakes on EUS staging of colorectal carcinoma: error in interpretation or deception from innate pathologic features? Gastrointest Endosc 51:682–689
Yoshimoto K, Sakai Y (2001) Golden standard of colorectal endoscopic ultrasonography for the definite diagnosis of colorectal cancer. Dig Endosc 13:S22–S26
Kobayashi K, Kida M, Katsumata T, et al (2003) Clinical role of endoscopic ultrasonography for the diagnosis of early colorectal cancer and selecting the treatment procedure. Dig Endosc 15:298–305
Kato S, Fujii T, Koba I, et al (2001) Assessment of colorectal lesions using magnifying colonoscopy and mucosal dye spraying: can significant lesions be distinguished? Endoscopy 33:306–310
Kudo S, Hirota S, Nakajima T, et al (1994) Colorectal tumours and pit pattern. J Clin Pathol 47:880–885
Kudo S, Rubio CA, Teixeira CR, et al (2001) Pit pattern in colorectal neoplasia: endoscopic magnifying view. Endoscopy 33:367–373
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
Kawano H, Tsuruta O, Ikeda H, et al (1998) Diagnosis of the level of depth in superficial depressed-type colorectal tumours in terms of stereomicroscopic pit patterns. Int J Oncol 12:769–775
Ohta A, Tominaga K, Sakai Y (2004) Efficacy of magnifying colonoscopy for the diagnosis of colorectal neoplasia: comparison with histological findings. Dig Endosc 16:308–314
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Fu, KI., Kato, S., Sano, Y. et al. Staging of Early Colorectal Cancers: Magnifying Colonoscopy versus Endoscopic Ultrasonography for Estimation of Depth of Invasion. Dig Dis Sci 53, 1886–1892 (2008). https://doi.org/10.1007/s10620-007-0104-y
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DOI: https://doi.org/10.1007/s10620-007-0104-y