Diagnostic Accuracy and Interobserver Agreement in Predicting the Submucosal Invasion of Colorectal Tumors Using Gross Findings, Pit Patterns, and Microvasculatures
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: Depth of invasion is one of the most important factors for establishing treatment strategy for colorectal tumors. Methods: Three blinded experts reviewed electronic photos and video clips of 33 early colorectal cancer-like lesions. They estimated the depth of invasion based on conventional white light endoscopy (CWE), magnifying chromoendoscopy (MCE), and magnifying narrow band imaging endoscopy (MNE). Results: The lesions included nine mucosal low-grade neoplasias, 16 mucosal high grade neoplasias, and eight carcinomas with invasion to the submucosal layer or beyond. The diagnostic accuracy for submucosal invasion by CWE ranged from 67% to 82%, while those by MCE and MNE ranged from 85% to 88% and 85% to 88%, respectively. The diagnostic accuracy significantly differed between CWE and MCE (p=0.034) and between CWE and MNE (p=0.039). The kappa values for CWE, MCE, and MNE among the endoscopists were 0.564, 0.673, and 0.673, respectively. Conclusions: The estimation of submucosal invasion for early colorectal cancer-like lesions based on MCE or MNE is more accurate than CWE. MCE and MNE were demonstrated to have substantial agreement for predicting submucosal invasion.
Abstract
Background/Aims: Depth of invasion is one of the most important factors for establishing treatment strategy for colorectal tumors. Methods: Three blinded experts reviewed electronic photos and video clips of 33 early colorectal cancer-like lesions. They estimated the depth of invasion based on conventional white light endoscopy (CWE), magnifying chromoendoscopy (MCE), and magnifying narrow band imaging endoscopy (MNE). Results: The lesions included nine mucosal low-grade neoplasias, 16 mucosal high grade neoplasias, and eight carcinomas with invasion to the submucosal layer or beyond. The diagnostic accuracy for submucosal invasion by CWE ranged from 67% to 82%, while those by MCE and MNE ranged from 85% to 88% and 85% to 88%, respectively. The diagnostic accuracy significantly differed between CWE and MCE (p=0.034) and between CWE and MNE (p=0.039). The kappa values for CWE, MCE, and MNE among the endoscopists were 0.564, 0.673, and 0.673, respectively. Conclusions: The estimation of submucosal invasion for early colorectal cancer-like lesions based on MCE or MNE is more accurate than CWE. MCE and MNE were demonstrated to have substantial agreement for predicting submucosal invasion.
참고문헌 (17)
- Kitajima K, "Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study", J Gastroenterol, 39 (2004)
- Ueno H, "Risk factors for an adverse outcome in early invasive colorectal carcinoma", Gastroenterology, 127, pp.385~394 (2004)
- Okabe S, "Lymph node metastasis in T1 adenocarcinoma of the colon and rectum", J Gastrointest Surg, 8, pp.1032~1039 (2004)
- Kudo S, "Pit pattern in colorectal neoplasia: endoscopic magnifying view", Endoscopy, 33, pp.367~373 (2001)
- Ikehara H, "Diagnosis of depth of invasion for early colorectal cancer using magnifying colonoscopy", J Gastroenterol Hepatol, 25, pp.905~912 (2010)
- Kanao H, "Narrowband imaging magnification predicts the histology and invasion depth of colorectal tumors", Gastrointest Endosc, 69(3 Pt 2), pp.631~636 (2009)
- Wada Y, "Diagnosis of colorectal lesions with the magnifying narrow-band imaging system", Gastrointest Endosc, 70, pp.522~531 (2009)
- Ikematsu H, "Efficacy of capillary pattern type IIIA", IIIB by magnifying narrow band imaging for estimating depth of invasion of early colorectal neoplasms, 2010, pp.10, 33~
- Mainprize KS, "Early colorectal cancer: recognition, classification and treatment", Br J Surg, 85, pp.469~476 (1998)
- Kudo S, "Endoscopic diagnosis and treatment of early colorectal cancer", World J Surg, 21, pp.694~701 (1997)
- Dixon MF, "Gastrointestinal epithelial neoplasia: Vienna revisited", Gut, 51, pp.130~131 (2002)
- Kudo S, "Diagnosis of colorectal tumorous lesions by magnifying endoscopy", Gastrointest Endosc, 44, pp.8~14 (1996)
- Wada Y, "Vascular pattern classification of colorectal lesions with narrow band imaging magnifying endoscopy", Dig Endosc, 23(Suppl 1), pp.106~111 (2011)
- Tanaka S, "Aim to unify the narrow band imaging (NBI) magnifying classification for colorectal tumors: current status in Japan from a summary of the consensus symposium in the 79th Annual Meeting of the Japan Gastroenterological Endoscopy Society", Dig Endosc, 23(Suppl 1), pp.131~139 (2011)
- 지정선, "조기 대장암의 육안적 심달도 진단에 있어 관찰자간 일치도", Clinical Endoscopy, 31(1), pp.39~43 (2005), 대한소화기내시경학회
- Kashida H, "Early colorectal cancer: concept, diagnosis, and management", Int J Clin Oncol, 11, pp.1~8 (2006)
- Sung HY, "Polyps in the gastrointestinal tract: discrepancy between endoscopic forceps biopsies and resected specimens", Eur J Gastroenterol Hepatol, 21, pp.190~195 (2009)