AIM:To assess the efficacy of endocytoscopic narrowband imaging(EC-NBI)for evaluating the severity of inflammation in ulcerative colitis(UC).METHODS:This retrospective study was conducted at a single tertiary care ref...AIM:To assess the efficacy of endocytoscopic narrowband imaging(EC-NBI)for evaluating the severity of inflammation in ulcerative colitis(UC).METHODS:This retrospective study was conducted at a single tertiary care referral center.We included UC patients who underwent colonoscopy with endocytoscopy from July 2010 to December 2013.ECNBI was performed,and the images were evaluated by assessing visibility,increased vascularization,and the increased calibers of capillaries and were classified as Obscure,Visible or Dilated.Obscure was indicative of inactive disease,while Visible and Dilated were indicative of acute inflammation.This study received Institutional Review Board approval.The primary outcome measures included the diagnostic ability of EC-NBI to distinguish between active and inactive UC on the basis of histological activity.The conventional endoscopic images were classified according to the Mayo endoscopic score.A score of 0 or 1 indicated inactive disease,whereas a score of 2 indicated active disease.RESULTS:Fifty-two patients were enrolled.There was a strong correlation between the EC-NBI findings and the histological assessment(r=0.871,P<0.01).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of EC-NBI for diagnosing acute inflammation were 84.0%,100%,87.1%,100%,and 92.3%,respectively,while those for the Mayo endoscopic score were 100%,40.7%,100%,61.0%,and 69.2%,respectively.Compared with conventional endoscopy,EC-NBI was superior in diagnostic specificity,negative predictive value,and accuracy(P<0.001,P=0.001 and P=0.047,respectively).CONCLUSION:The EC-NBI finding of capillaries in the rectal mucosa was strongly correlated with histological inflammation and aided in the differential diagnosis between active and inactive UC.展开更多
BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the sub...BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.展开更多
文摘AIM:To assess the efficacy of endocytoscopic narrowband imaging(EC-NBI)for evaluating the severity of inflammation in ulcerative colitis(UC).METHODS:This retrospective study was conducted at a single tertiary care referral center.We included UC patients who underwent colonoscopy with endocytoscopy from July 2010 to December 2013.ECNBI was performed,and the images were evaluated by assessing visibility,increased vascularization,and the increased calibers of capillaries and were classified as Obscure,Visible or Dilated.Obscure was indicative of inactive disease,while Visible and Dilated were indicative of acute inflammation.This study received Institutional Review Board approval.The primary outcome measures included the diagnostic ability of EC-NBI to distinguish between active and inactive UC on the basis of histological activity.The conventional endoscopic images were classified according to the Mayo endoscopic score.A score of 0 or 1 indicated inactive disease,whereas a score of 2 indicated active disease.RESULTS:Fifty-two patients were enrolled.There was a strong correlation between the EC-NBI findings and the histological assessment(r=0.871,P<0.01).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of EC-NBI for diagnosing acute inflammation were 84.0%,100%,87.1%,100%,and 92.3%,respectively,while those for the Mayo endoscopic score were 100%,40.7%,100%,61.0%,and 69.2%,respectively.Compared with conventional endoscopy,EC-NBI was superior in diagnostic specificity,negative predictive value,and accuracy(P<0.001,P=0.001 and P=0.047,respectively).CONCLUSION:The EC-NBI finding of capillaries in the rectal mucosa was strongly correlated with histological inflammation and aided in the differential diagnosis between active and inactive UC.
文摘BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.
