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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2022; 14(8): 495-501
Published online Aug 16, 2022. doi: 10.4253/wjge.v14.i8.495
New application of endocytoscope for histopathological diagnosis of colorectal lesions
Fumihiro Inoue, Daizen Hirata, Mineo Iwatate, Santa Hattori, Mikio Fujita, Wataru Sano, Tamotsu Sugai, Hiroshi Kawachi, Kazuhito Ichikawa, Yasushi Sano
Fumihiro Inoue, Daizen Hirata, Mineo Iwatate, Santa Hattori, Mikio Fujita, Wataru Sano, Yasushi Sano, Gastrointestinal Center and Institute of Minimally-invasive Endoscopic Care (i-MEC), Sano Hospital, Kobe 655-0031, Hyogo, Japan
Tamotsu Sugai, Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Shiwa-gun 028-3694, Iwate, Japan
Hiroshi Kawachi, Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto 135-8550, Tokyo, Japan
Kazuhito Ichikawa, Department of Pathology, Noda Hospital, Noda 270-0237, Chiba, Japan
Author contributions: Inoue F, Hirata D, Iwatate M, Hattori S, Fujita M, Sano W and Sano Y contributed to the study concept and design; Sugai T, Kawachi H and Ichikawa K contributed to read endocytopathological images; Inoue F, Hirata D, Iwatate M and Sano Y contributed to the data analysis and interpretation; Inoue F contributed to draft the manuscript; and Sugai T, Kawachi H, Ichikawa K and Sano Y contributed to the critical revision of the manuscript for intellectual content.
Institutional review board statement: The study protocol was reviewed and approved by the Institutional Review Board at Sano Hospital (No. 202106-02).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Mineo Iwatate, Doctor, Gastrointestinal Center and Institute of Minimally-invasive Endoscopic Care (i-MEC), Sano Hospital, 2-5-1 Shimizugaoka, Tarumi-ku, Kobe 655-0031, Hyogo, Japan. m.iwatate15@gmail.com
Received: February 18, 2022
Peer-review started: February 18, 2022
First decision: April 12, 2022
Revised: April 23, 2022
Accepted: July 20, 2022
Article in press: July 20, 2022
Published online: August 16, 2022
BACKGROUND
The endocytoscope with ultra-high magnification (x 520) allows us to observe the cellular structure of the colon epithelium during colonoscopy, known as virtual histopathology. We hypothesized that the endocytoscope could directly observe colorectal histopathological specimens and store them as endocyto-pathological images by the endoscopists without a microscope, potentially saving the burden on histopathologists.
AIM
To assess the feasibility of endocyto-pathological images taken by an endoscopist as adequate materials for histopathological diagnosis.
METHODS
Three gastrointestinal pathologists were invited and asked to diagnose 40 cases of endocyto-pathological images of colorectal specimens. Each case contained seven endocyto-pathological images taken by an endoscopist, consisting of one loupe image, three low-magnification images, and three ultra-high magnification images. The participants chose hyperplastic polyp or low-grade adenoma for 20 cases of endocyto-pathological images (10 hyperplastic polyps, and 10 Low-grade adenomas in conventional histopathology) in study 1 and high-grade adenoma/ shallow invasive cancer or deep invasive cancer for 20 cases [10 tumor in situ/T1a and 10 T1b] in study 2. We investigated the agreement between the histopathological diagnosis using the endocyto-pathological images and conventional histopathological diagnosis.
RESULTS
Agreement between the endocyto-pathological and conventional histopathological diagnosis by the three gastrointestinal pathologists was 100% (95%CI: 94.0%–100%) in studies 1 and 2. The interobserver agreement among the three gastrointestinal pathologists was 100%, and the κ coefficient was 1.00 in both studies.
CONCLUSION
Endocyto-pathological images were adequate and reliable materials for histopathological diagnosis.
Core Tip: The endocytoscope allows us to observe the histological structure of the colon epithelium, but it is a virtual histopathology. We directly observed pathological specimens by the endocytoscope and evaluated the practical usefulness of endocyto-pathology in this pilot study.
