Endoscopy 2010; 42(12): 1057-1062
DOI: 10.1055/s-0030-1255742
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Small-bowel capsule endoscopy diagnoses early and advanced neoplasms in asymptomatic patients with Lynch syndrome

J.-C.  Saurin1 , F.  Pilleul2 , E.  B.  Soussan3 , T.  Manière4 , P.  N.  D’Halluin5 , M.  Gaudric6 , C.  Cellier4 , D.  Heresbach5 , J.-L.  Gaudin7, and the Capsule Commission of the French Society of Digestive Endoscopy (SFED)
  • 1Centre Hospitalier Lyon Sud, Pierre Bénite, France
  • 2Hôpital E. Herriot, Lyon, France
  • 3Clinique du Trocadero, Paris, France
  • 4Hôpital Européen Georges Pompidou, Paris, France
  • 5Centre Hospitalier Universitaire de Rennes, Rennes, France
  • 6Hôpital Cochin, Paris, France
  • 7Centre Hospitalier Lyon Sud, Pierre Bénite, France
Further Information

Publication History

submitted 26 January 2010

accepted after revision 9 July 2010

Publication Date:
06 September 2010 (online)

Background and study aims: Patients with Lynch syndrome are at increased risk of developing small-bowel adenocarcinoma, which usually has a bad prognosis and needs to be diagnosed early. Our aim was to evaluate the yield of capsule endoscopy and CT enteroclysis in this situation.

Patients and methods: We performed a prospective, blinded, comparative study of capsule endoscopy and CT enteroclysis in five academic centers. Thirty-five consecutive asymptomatic patients with Lynch syndrome, all with one proven deleterious mutation, were included. A double reading was performed blind for both types of examination.

Results: Histologically confirmed small-bowel neoplasms were diagnosed in three patients (8.6 %): one adenocarcinoma (T3N0M0) and two adenomas with low-grade dysplasia. Capsule endoscopy identified all neoplasms. CT enteroclysis raised suspicion of one neoplasm (adenocarcinoma) but missed the two others. Concordance between the two capsule readings was high with a κ value of 0.78 (95 %CI 0.55 to 1.0), which was not the case for CT enteroclysis, where the κ value was 0.15 (95 %CI –0.27 to 0.58).

Conclusion: Curable early or advanced neoplasms in asymptomatic patients with Lynch syndrome using capsule endoscopy can be detected with a better reproducibility than with CT enteroclysis. The clinical usefulness of systematic small-bowel screening in these patients should be confirmed through large prospective studies.


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J.-C. SaurinMD 

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Email: jean-christophe.saurin@inserm.fr