Published online Apr 15, 2018. doi: 10.4251/wjgo.v10.i4.96
Peer-review started: December 17, 2017
First decision: January 6, 2018
Revised: January 10, 2018
Accepted: March 6, 2018
Article in press: March 6, 2018
Published online: April 15, 2018
Endocytoscopy, which will be newly launched in 2018, allows us to observe both structural and cellular atypia in vivo. The Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) document described key thresholds for assessing the histology of diminutive polyps (≤ 5 mm) using endoscopic technology. However, few studies about endocytoscopy have examined its diagnostic performance for diminutive colorectal polyps.
This study before the launch of endocytoscopy can help to understand the usefulness of endocytoscopy.
To clarify the diagnostic performance of endocytoscopy for differentiating neoplastic from non-neoplastic diminutive colorectal polyps.
We prospectively recruited patients who underwent endocytoscopy between October and December 2016 at Sano Hospital. Diminutive polyps were evaluated by endocytoscopy after being stained with 0.05% crystal violet and 1% methylene blue. The diminutive polyps were classified according to the endocytoscopic (EC) classification. Endoscopists have assessed the diagnostic performance of endocytoscopy for EC2 (indicator of adenoma) and EC1b (indicator of hyperplastic polyp) lesions by comparison with the histopathology of the biopsy specimen.
A total of 39 patients with 63 diminutive polyps were analyzed. The accuracy and negative predictive value of EC2 for adenoma compared with EC1b for hyperplastic polyp were 98.0% and 92.3%. Endocytoscopy showed a high diagnostic performance for differentiating between neoplastic and non-neoplastic colorectal diminutive polyps. However, because endocytoscope was available to our institute for only a limited period, the number of samples was small.
The diagnostic performance of endocytoscopy for colorectal diminutive polyps met the PIVI criteria for assessment of histology.
Real-time histopathologic assessment by endocytoscopy has the potential to save histopathological diagnosis. Additional multicenter studies are needed to confirm our result.