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 Sako
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
2  Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Shin-ei Kudo
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Hideyuki Miyachi
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
3  Miyachi Clinic, Kakogawa, Japan
,
Kunihiko Wakamura
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Kenta Igarashi
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Masashi Misawa
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Yuichi Mori
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Toyoki Kudo
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Takemasa Hayashi
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Atsushi Katagiri
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Fumio Ishida
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Takeshi Azuma
2  Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Haruhiro Inoue
4  Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Shigeharu Hamatani
1  Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
5  Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
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Publikationsverlauf

submitted 21. März 2017

accepted after revision 26. Juni 2017

Publikationsdatum:
29.September 2017 (eFirst)

Abstract

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.