Naslov
The role of standard videochromocolonoscopy in distinguishing adenomatous from nonadenomatous diminutive colorectal polyps

Autori
Ljubičić, Neven ; Kujundžić, Milan ; Banić, Marko ; Roić, Goran

Izvornik
Acta clinica Croatica (0353-9466) 40 (2001); 197-201

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
Colonic neoplasms-diagnosis; colonic polyps-diagnosis; adenoma-diagnosis; colonoscopy-methods

Sažetak
To date, there are no reliable endoscopic criteria to discriminate a diminutive (<5 mm) colorectal adenomatous from nanadenomatous polyps. Studies have demonstrated the usefulness of high &#8211; resolution chromoendoscopy (high-resolution colonoscopy with topically applied indigo carmine dye) in discrimination of adenomatous from nonadenomatous colorectal polyps. However, the clinical utility of standard videocolonoscopy and chromoscopy with indigo carmine dye in differentiating diminutive colorectal polyps had not yet been defined. The aim of this study was to determine whether a combination of standard videocolonoscopy and staining with indigo carmine dye could differentiate between adenomatous and nonadenomatous colorectal polyps smaller than 5 mm. Colonoscopy by use of an Olympus EVIS 140 video system was performed in 42 patients in whom colorectal polyps smaller than 5 mm were found. Polyps were sprayed with up zo 40 ml of 0.5 % indigo carmine dye, and polypectomy was perfprmed, and the material was referred for histology. In 42 patients included in the study, 48 polyps sized <5 mm were detected. Histologic analysis showed 14 of them to be adenomatous and 34 nonadenomatous polyps. Endoscopist's diacnosis was confirmed by histology in 12 of 14 (85.7 %) adenomatous and 31 of 34 (91.2 %) nonadenomatous colorectal diminutive polyps. The sensitivity, specificity, positive predictive value and negative predictive value of standard videochromocolonoscopy in distinguishing between adenomatous and nonadenomatous polyps sized <5 mm were 85.7 %, 91.2 %, 80 % and 93.9 %, respectively. The likehood ratios (LR) were 0.157 (LR-) and 9.74 (LR+). In conclusion, standard videocolonoscopy combined with indigo carmine dye is a reliable method to differentiate adenomatous from nonadenomatous colorectal polyps sized <5 mm. Such a technique could limit the requests for unnecessary biopsies and repeat colonoscopy, thus significantly reducing the cost of colorectal cancer screening.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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