Novosti
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This journal is indexed in Scopus |
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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 University”1,
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 non–neoplastic, neoplastic lesions and early colorectal cancer have been established.
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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
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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