Background
We previously reported on the efficacy of endocytoscopic classification (EC-C). However,
the correlation of the endocytoscopic vascular (EC-V) pattern with diagnoses was unclear.
Objective
To assess the diagnostic accuracy of the EC-V pattern for colorectal lesions.
Design
Retrospective.
Setting
A university hospital.
Patients
Patients who underwent endocytoscopy between January 2010 and March 2013.
Intervention
We evaluated 198 consecutive lesions according to the EC-V pattern (EC-V1, obscure
surface microvessels; EC-V2, clearly observed surface microvessels of a uniform caliber
and arrangement; and EC-V3, dilated surface microvessels of a nonhomogeneous caliber
or arrangement).
Main Outcome Measurements
The diagnostic accuracy for predicting hyperplastic polyps and invasive cancer were
compared between the EC-V pattern and other modalities (narrow-band imaging, pit pattern,
and EC-C).
Results
The sensitivity, specificity, and accuracy of the EC-V1 pattern for diagnosing hyperplastic
polyps were 95.5%, 99.4%, and 99.0%, respectively. The sensitivity, specificity, and
accuracy of the EC-V3 pattern for diagnosing invasive cancer were 74.6%, 97.2%, and
88.6%, respectively. The diagnostic accuracy of the EC-V pattern for predicting hyperplastic
polyps was comparable to the other modalities. For predicting invasive cancer, the
EC-V pattern was comparable to narrow-band imaging and pit pattern, although EC-C
was slightly more accurate (P = .04). In the substudy, the diagnosis time by using the EC-V pattern was shorter
than that with the EC-C pattern (P < .001).
Limitations
A single-center, retrospective study.
Conclusions
The EC-V pattern saved more time than the EC-C pattern and had a diagnostic ability
comparable to that of other optical biopsy modalities.
Abbreviations:
CI (confidence interval), CLE (confocal laser endomicroscopy), EC (endocytoscopy), EC-C (endocytoscopy classification based on glandular and cellular atypia), EC-NBI (endocytoscopy in conjunction with narrow-band imaging), EC-V (endocytoscopic vascular pattern), NBI (narrow-band imaging), NBI-ME (magnifying endoscopy with narrow-band imaging), PIT (pit pattern), SSA/P (sessile serrated adenoma/polyp), VC (Vienna classification)To read this article in full you will need to make a payment
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References
- Colorectal tumours and pit pattern.J Clin Pathol. 1994; 47: 880-885
- Pit pattern in colorectal neoplasia: endoscopic magnifying view.Endoscopy. 2001; 33: 367-373
- Appearance of enhanced tissue features in narrow-band endoscopic imaging.J Biomed Opt. 2004; 9: 568-577
- Microvascular structure of benign and malignant tumors of the colon in humans.Dig Dis Sci. 1995; 40: 373-384
- 3D microvascular architecture of pre-cancerous lesions and invasive carcinomas of the colon.Br J Cancer. 2001; 84: 1354-1362
- Geometric resistance and microvascular network architecture of human colorectal carcinoma.Microcirculation. 1997; 4: 25-33
- Magnifying observation of microvascular architecture of colorectal lesions using a narrow-band imaging system.Dig Endosc. 2006; 18: S44-51
- Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia.Aliment Pharmacol Ther. 2008; 27: 1269-1274
- Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors.Gastrointest Endosc. 2009; 69: 631-636
- Diagnosis of colorectal lesions with the magnifying narrow-band imaging system.Gastrointest Endosc. 2009; 70: 522-531
- Imaging by magnifying endoscopy with NBI implicates the remnant capillary network as an indication for endoscopic resection in early colon cancer.Int J Surg Oncol. 2011; 2011: 242608
- Diagnostic accuracy of pit pattern and vascular pattern analyses in colorectal lesions.Dig Endosc. 2010; 22: 192-199
- Diagnosis of colorectal lesions with a novel endocytoscopic classification-a pilot study.Endoscopy. 2011; 43: 869-875
- Real-time in vivo virtual histology of colorectal lesions when using the endocytoscopy system.Gastrointest Endosc. 2006; 63: 1010-1017
- Comprehensive diagnostic ability of endocytoscopy compared with biopsy for colorectal neoplasms: a prospective randomized noninferiority trial.Endoscopy. 2013; 45: 98-105
- Endocytoscopy can provide additional diagnostic ability to magnifying chromoendoscopy for colorectal neoplasms.J Gastroenterol Hepatol. 2014; 29: 83-90
- Correlation between endocytoscopy and conventional histopathology in microstructural features of ulcerative colitis.J Gastroenterol. 2011; 46: 1197-1202
- Japanese classification of colorectal carcinoma.Kanehara & Co, Ltd, Tokyo (Japan)2009
- Nonpolypoid neoplastic lesions of the colorectal mucosa.Gastrointest Endosc. 2008; 68: S3-47
- Gastrointestinal epithelial neoplasia: Vienna revisited.Gut. 2002; 51: 130-131
- Three-dimensional analysis of tumour vascular corrosion casts using stereoimaging and micro-computed tomography.Microvasc Res. 2010; 80: 89-98
- Optical/digital chromoendoscopy during colonoscopy using narrow-band imaging system.Dig Endosc. 2005; 17: S43-S48
- In vivo real-time endocytoscopic visualization of blood flow in rectal microvasculature.Endoscopy. 2008; 40: 534-536
- Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis.World J Gastroenterol. 2015; 21: 2108-2115
- Endomicroscopy and cancer: a new approach to the visualization of neoangiogenesis.Gastroenterol Res Pract. 2012; 2012: 537170
- Endoscopic in vivo evaluation of tissue atypia in the esophagus using a newly designed integrated endocytoscope: a pilot trial.Endoscopy. 2006; 38: 891-895
- Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy.Science. 2005; 307: 58-62
- Normalization of the vasculature for treatment of cancer and other diseases.Physiol Rev. 2011; 91: 1071-1121
- Sessile serrated adenomas: prevalence of dysplasia and carcinoma in 2139 patients.J Clin Pathol. 2010; 63: 681-686
Article info
Publication history
Published online: June 09, 2015
Accepted:
April 26,
2015
Received:
January 13,
2015
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
