High-resolution chromoendoscopy for classifying colonic polyps: a multicenter study

被引:81
作者
Eisen, GM [1 ]
Kim, CY [1 ]
Fleischer, DE [1 ]
Kozarek, RA [1 ]
Carr-Locke, DL [1 ]
Li, TCM [1 ]
Gostout, CJ [1 ]
Heller, SJ [1 ]
Montgomery, EA [1 ]
Al-Kawas, FH [1 ]
Lewis, JH [1 ]
Benjamin, SB [1 ]
机构
[1] Mayo Clin Scottsdale, Div Gastroenterol Hepatol, Scottsdale, AZ 85259 USA
关键词
D O I
10.1067/mge.2002.123619
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Chromoendoscopy may reliably separate adenomatous from nonadenomatous polyps. The aim of this multicenter trial was to determine the accuracy of high-resolution chromoendoscopy for the determination of colonic polyp histology. Methods: This multicenter trial included 4 academic centers and a primary care practice. In 299 patients referred for routine colonoscopy or sigmoidoscopy, 520 polyps 10 mm in size were sprayed with indigo carmine dye. Using a high-resolution endoscope, the endoscopist predicted the histology of each polyp based on its surface characteristics. Hyperplastic polyps had a "pitted" surface pattern of orderly arranged "dots" that resembled surrounding normal mucosa. Adenomatous polyps had at least one surface "groove" or "sulcus." Each polyp was subsequently resected for histopathologic evaluation. Results: The resected polyps were comprised by 193 adenomas (37%), 225 hyperplastic polyps (43%), and 102 "other" types (20%). Forty polyps (7.7%) could not be classified by high resolution chromoendoscopy with indigo carmine dye. For the remaining polyps, the sensitivity, specificity, and negative predictive value of indigo carmine dye staining for adenomatous polyps were, respectively, 82%,82%, and 88%. The results were consistent among the academic centers and the primary care practice. Conclusions: High-resolution chromoendoscopy with indigo carmine dye demonstrates morphologic detail of diminutive colorectal polyps that can reliably be used to separate adenomatous from nonadenomatous polyps.
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页码:687 / 694
页数:8
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