Year 2013 Vol. 21 No 1

ENDOSKOPY

V.I. RUSYN 1, P.A. BOLDIZHAR 1, A.V. SOCHKA 2

CHROMOCOLONOSCOPY AS A METHOD OF ENDOSCOPICAL IMAGE IMPROVEMENT

SHEE Uzhgorod National University1,
Transcarpatian Regional Clinical oncological hospitaL 2, Uzhgorod. The Ukraine

Objectives. To study the diagnostic significance of chromocolonoscopy with methylene blue for the differential diagnostics between non-neoplastic, neoplastic growth of the colon and the early colorectal cancer.
Methods. The results of chromoendoscopical and histological examination of 211 colorectal polyps are presented in the paper. The videocolonoscopy and chromoscopy (0,2-0,5% solution of methylene blue) were used to improve visualization of the abnormal tissue.
Endoscopic conclusions were made on the basis of Pit Pattern classification which includes 5 types of structures of the pit epithelium: I and II types reflect a norm, inflammation and hyperplasia; III-V types reflect neoplasia. The results of the visual endoscopic interpretation were compared with the histological analysis data.
Results. Out of total number of the colorectal lesions, 171 (81,0%) were adenomas, 39 (18,5%) non-neoplastic polyps, 1(0,5%) a polypoid form of early colon cancer (type Ip).
151 adenomas (88,3%) out of 171 were benign ones: 103 (68,2%) tubular, 29 (19,2%) tubular-villous, 19 (12,6%) villous ones. Malignant degenerations were diagnosed in 20 (11,7%) adenomas.
After chromocolonoscopy the number of false-negative results of the visual differential diagnostics between non-neoplastic, neoplastic growths of the colon and the early colorectal cancer decreased up to 10,3-28,6% in comparison with 30-50% after a standard colonoscopy. The largest number of false-negative results was observed in the group of malignant adenomas (28,6%), significantly less in the groups of benign adenomas (13,2%) and non-neoplastic polyps (10,3%).
Sensitivity and specificity of chromocolonoscopy to diagnose non-neoplastic growths made up 89,7% and 95,9%, correspondently, to diagnose neoplastic growths 86,8% and 93,3%, to diagnose cancer 71,4% and 96,8%.
Conclusions. A high sensitivity and specificity of chromocolonoscopy for differential diagnosis between nonneoplastic, neoplastic lesions and early colorectal cancer have been established.

Keywords: colonoscopy, chromoscopy, methylene blue, polyps
p. 70 77 of the original issue
References
  1. Banks MR, Haidry R, Butt MA, Whitley L, Stein J, Langmead L, Bloom SL, O'Bichere A, McCartney S, Basherdas K, Rodriguez-Justo M, Lovat LB. High resolution colonoscopy in a bowel cancer screening program improves polyp detection. World J Gastroenterol. 2011 Oct 14;17(38):430813.
  2. Rabeneck L, Paszat LF. Circumstances in which colonoscopy misses cancer. Frontline Gastroenterology. 2010;1:5258.
  3. Fomn P.D., Nkshaev V.. Termnologja klassfkacja metodov poluchenja jendoskopcheskogo zobrazhenja [Terminology and classification of methods for endoscopic image]. Ukran Zhurn Maloinvazv ta Endoskopich Hirurgi. 2011;15(3):1318
  4. Nkshaev V, Patj AR, Tumak N, Koljada A. Jendoskopcheskaja dagnostka rannego kolorektal"nogo raka [Endoscopic diagnosis of early colorectal cancer]. Ukran Zhurn Maloinvazv ta Endoskopich Hirurgi. 2012;16(1):3555.
  5. Hafner M, Liedlgruber M, Uhl A, Vecsei A, Wrba F. Delaunay triangulation-based pit density estimation for the classification of polyps in high-magnification chromo-colonoscopy. Comput Methods Programs Biomed. 2012 Sep;107(3):56581.
  6. Kanao H, Tanaka S, Oka S, Kaneko I, Yoshida S, Arihiro K, Yoshihara M, Chayama K. Clinical significance of type V(I) pit pattern subclassification in determining the depth of invasion of colorectal neoplasms. World J Gastroenterol. 2008 Jan 14;14(2):21117.
  7. Tominaga K, Fujinuma S, Endo T, Saida Y, Takahashi K, Maetani I. Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias. World J Gastroenterol. 2009 May 21;15(19):235156.
Address for correspondence:
88014, Ukraina, g. Uzhgorod, ul. Brodlakovicha, d. 2, Zakarpatskii oblastnoi klinicheskii onkologicheskii dispanser, poliklinicheskoe otdelenie, endoskopicheskii kabinet,
e-mail:sochka_anna@inbox.ru,
Sochka Anna Vladimirovna
Information about the authors:
Rusin V.I. MD, professor, head of the surgical diseases chair of the medical faculty of SHEE Uzhgorod National University.
Boldizhar P.A. MD, professor of the surgical diseases chair of the medical faculty of SHEE Uzhgorod National University.
Sochka A.V. Post graduate student of the surgical diseases chair of the medical faculty of SHEE Uzhgorod National University, endoscopist of the out-patient department of Transcarpatian regional clinical oncological hospital.
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