| Theme |
Frontier of image diagnosis for colorectal carcinoma |
| Title |
Colorectal endocytoscopy |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Kunihiko Wakamura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Nobunao Ikehara |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Keita Sasajima |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yoshiki Wada |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Haruhiro Inoue |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shigeharu Hamatani |
Department of Pathology, Showa University Northern Yokohama Hospital |
| [ Summary ] |
In this study, we used an integrated type EC (XCF-260EC1, OLYMPUS, Tokyo, Japan). We classified the EC findings into 6 groups and evaluated whether the classification obtained were useful for differential diagnosis. There were 165 subjects with lesions, observed from May 2005 to December 2008. The lesions were detected through ordinary views, stained with 1% methylene blue, and observed with EC observation. EC0a : uniform glands with round lumen, EC0b : uniform glands with serrated lumen, EC1a : uniform glands with slit-like lumen and faintly stained fusiform nuclei and EC1b : found uniform glands with enlarged and darkly stained nuclei. EC2 : indicated irregularly shaped glands with enlarged and distorted nuclei. EC3 : illustrated destroyed gland structures with enlarged and distorted nuclei. The final pathological diagnosis indicated normal mucosa in 6 cases, hyperplastic polyps in 7 cases, adenomas in 61 cases, mucosal cancer-slightly invasive in 35 cases and massively invasive cancer in 56 cases. The positive predictive values for each EC group were as follows. EC0 (non-tumor) : 100%, EC1a : (adenoma) : 95.1% and EC3 (invasive cancer) : 98.0%. The integrated type EC system allowed us to observe colorectal lesions at the cellular level in vivo. Our new classification of EC images corresponded well with the final pathological diagnosis. Endocytoscopy was especially useful for differential diagnosis of neoplastic and non-neoplastic lesions. |