High-definition endoscopy with digital chromoendoscopy for histologic prediction of distal colorectal polyps

BMC Gastroenterology

Helmut Neumann³  Markus F. Neurath³  Arthur Hoffman¹  Claudia Günther³  Steffen Zopf³  Michael Vieth²  Andreas Nägel³  Gian E. Tontini³  Timo Rath³ 

[1] Department of Medicine II, HSK Wiesbaden, Wiesbaden, Germany;Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany;Interdisciplinary Endoscopy, Department of Medicine I, University Hospital Erlangen, Ulmenweg 18, Erlangen, 91054, Germany

关键词: Polyps;    Histology;    Gastrointestinal endoscopy;    Colorectal cancer;    Adenomas;   

Others  :  1234332
DOI  :  10.1186/s12876-015-0374-3

 received in 2015-05-27, accepted in 2015-10-13,  发布年份 2015

【 摘 要 】

Background

Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement.

Methods

In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital chromoendoscopy and the accuracy of predicting histology with digital chromoendoscopy was assessed.

Results

The overall accuracy of digital chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital chromoendoscopy were correctly predicted with >90 % accuracy.

Conclusions

High-definition endoscopy in combination with digital chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps.

Trial registration

ClinicalTrials NCT02217449.

【 授权许可】

   
2015 Rath et al.

【 图 表 】

Fig. 1.

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