TITLE

FLAT AND DEPRESSED COLORECTAL LESIONS HAVE A HIGH MALIGNANT POTENTIAL IN THE UK: A PROSPECTIVE STUDY USING HIGH RESOLUTION CHROMOSCOPIC COLONOSCOPY

AUTHOR(S)
Hurlstone, D.P.; Shorthouse, A.J.; Adam, I.; Brown, S.; Cross, S.S.; Korulla, C.; Davies, R.; Lobo, A.J.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA33
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: Flat and depressed colorectal (CR) lesions are well described in Japanese and now western European cohorts. Studies assessing their malignant potential have shown high variability. Detection using conventiona/colonoscopy can be difficult. High resolution chromoscopic colonoscopy (HRCC) may facilitate detection of such lesions and allow histological characteristics to be predicted in vivo. Aim: To evaluate the efficacy of HRCC in predicting the malignant potential of flat CR lesions. Subjects and Methods: Total colonoscopy was performed on 600 consecutive patients, by a single endoscopist using the Olympus CF240Z endoscope from 01/02 to 09/02. Locally applied 0.5% indigo carmine (lC) was used to facilitate crypt pattern appearance oF all flat lesions, graded according to the modified Kudo class. Morphology was documented using the Japanese Research Society Classification (JRSC). Endoscopic Mucosal Resection (EMR) was performed on all lesions unless > 20mm diameter, had evidence of a type V(n)/V(a)/llls crypt pattern, or those demonstrable of asymmetrical "lift". Histological analysis was obtained on all specimens. Lesions excluded from EMR were cold biopsied and marked with an intramucosal tattoo or endoclip.Results: See table. Conclusions: Flat depressed CR lesions exhibit a high malignant potential in the UK. HRCC is a useful tool when predicting histological type in vivo.
ACCESSION #
9747480

 

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