Endoscopy 2018; 50(01): 69-74
DOI: 10.1055/s-0043-117403
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A novel ability of endocytoscopy to diagnose histological grade of differentiation in T1 colorectal carcinomas

Tomoya Sako1, 2, Shin-ei Kudo1, Hideyuki Miyachi1, 3, Kunihiko Wakamura1, Kenta Igarashi1, Masashi Misawa1, Yuichi Mori1, Toyoki Kudo1, Takemasa Hayashi1, Atsushi Katagiri1, Fumio Ishida1, Takeshi Azuma2, Haruhiro Inoue4, Shigeharu Hamatani1, 5
  • 1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
  • 2Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
  • 3Miyachi Clinic, Kakogawa, Japan
  • 4Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
  • 5Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
Further Information

Publication History

submitted 21 March 2017

accepted after revision 26 June 2017

Publication Date:
29 September 2017 (eFirst)


Background and study aims Endocytoscopic images closely resemble histopathology. We assessed whether endocytoscopy could be used to determine T1 colorectal cancer histological grade.

Patients and methods Endocytoscopic images of 161 lesions were divided into three types: tubular gland lumens, unclear gland lumens, and fused gland formations on endocytoscopy (FGFE). We retrospectively compared endocytoscopic findings with histological grade in the resected specimen superficial layer, and examined the incidence of risk factors for lymph node metastasis.

Results Of the 118 eligible lesions, the sensitivity, specificity, accuracy, negative predictive value, and positive likelihood ratio of tubular or unclear gland lumens to identify well-differentiated adenocarcinomas were 91.0 %, 93.1 %, 91.5 %, 77.1 %, and 13.20, respectively. To identify moderately differentiated adenocarcinomas for FGFE, these values were 93.1 %, 91.0 %, 91.5 %, 97.6 %, and 10.36, respectively. In the 35 lesions with FGFE, the rates of massive invasion, lymphovascular infiltration, and tumor budding were 97.1 %, 60.0 %, and 37.1 %, respectively.

Conclusions Endocytoscopy could be used to diagnose T1 colorectal cancer histological grade, and FGFE was a marker for recommending surgery.