Theme |
Development of diagnosis of magnifying endoscopy |
Title |
Efficacy of magnifying colonoscopy in diagnosing the depth of invasion of colorectal cancer |
Author |
Takahisa Matsuda |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Yutaka Saito |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Toshio Uraoka |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Hisatomo Ikehara |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Yumi Mashimo |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Tsuyoshi Kikuchi |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Naoko Okabe |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Kohei Takizawa |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Yoko Tateishi |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Daizo Saito |
Division of Endoscopy, National Cancer Center Hospital |
Author |
Yasushi Sano |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
Author |
Takahiro Fujii |
Takahiro Fujii Clinic |
[ Summary ] |
It has been said that is possible to estimate the depth of invasion of neoplastic colorectal lesions using magnifying colonoscopy in order to decide the correct treatment. Magnifying colonoscopy identifies a typical pattern, termed “invasive pattern”, which consists of irregular, distorted colonic gland crypts in a demarcated area. This type of pattern corresponds to submucosal deep (sm2 - 3) invasive cancer. It especially corresponds with completely destroyed muscularis mocosae. The calculated sensitivity, specificity, and accuracy were 85.6 %, 99.4 %, and 98.8 % respectively to differentiated intramucosal or sm1 invasion (<1,000 μm) from sm2 - 3 invasion (≥1,000 μm). Of the lesions which were endoscopically diagnosed as “invasive pattern”, a high percentage had invasive cancer, especially sm2 - 3 invasive cancer, where surgical resection is undoubtedly the proper treatment. |