Hyperplastic polyposis syndrome: a pilot study for the differentiation of polyps by using high-resolution endoscopy, autofluorescence imaging, and narrow-band imaging - 23/08/11
Reprint requests: Evelien Dekker, MD, PhD, Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.Amsterdam, The Netherlands
Abstract |
Background |
Endoscopic differentiation and removal of potentially premalignant sessile serrated adenomas (SSAs) may be important steps in preventing the development of colorectal cancer in hyperplastic polyposis syndrome (HPS).
Objective |
To assess the value of high-resolution endoscopy, autofluorescence imaging (AFI), and narrow-band imaging (NBI) for differentiating polyps in HPS.
Design |
A prospective polyp series.
Setting |
Single tertiary referral center.
Patients and Interventions |
Seven patients with HPS underwent colonoscopy with endoscopic trimodal imaging, which incorporates high-resolution endoscopy, AFI, and NBI in 1 system. All detected polyps were analyzed with AFI for color and with NBI for Kudo pit pattern and vascular pattern intensity.
Main Outcome Measurements |
The accuracy, sensitivity, and specificity of AFI and NBI in differentiating detected polyps were determined by using histology as the criterion standard.
Results |
A total of 19 hyperplastic polyps (HPs), 32 SSAs, and 15 adenomas were detected. For differentiating SSAs from HPs, AFI color, Kudo pit pattern, and vascular pattern intensity resulted in a diagnostic accuracy of 55%, 55%, and 52%, respectively. For differentiating adenomas from HPs, the accuracy was 65%, 94%, and 90%, respectively. Macroscopically, the combination of a size of 3 mm or larger and a proximal location resulted in the highest accuracy (76%) for differentiating SSAs from HPs.
Limitation |
Small sample size.
Conclusion |
Endoscopic differentiation between HPs and SSAs by using endoscopic trimodal imaging proved unsatisfactory. Differentiation of adenomas from HPs was possible with NBI but not with AFI.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : AFI, CI, CRC, ETMI, HRE, HP, HPS, NBI, SSA, TSA, VPI
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| DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: F.J.C. van den Broek is supported by an unrestricted educational grant from Olympus Medical Systems, Hamburg, Germany. P. Fockens has received a research grant from Olympus Inc, Tokyo, Japan. Olympus Medical Systems provided the Department of Gastroenterology at our institution with endoscopic equipment for this study. All other authors disclosed no financial relationships relevant to this publication. |
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| If you would like to chat with an author of this article, you may contact him at e.dekker@amc.uva.nl. |
Vol 70 - N° 5
P. 947-955 - novembre 2009 Ritorno al numero
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