Endocytoscopy in the Colorectum Shin-ei Kudo 1 , Nobunao Ikehara 1 , Kunihiko Wakamura 1 , Keita Sasajima 1 , Haruhiro Inoue 1 , Kazuo Ohtsuka 1 , Fumio Ishida 1 , Hiroshi Kashida 1 , Shigeharu Hamatani 2 1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan 2Division of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan Keyword: endocytoscopy , EC分類 , optical biopsy , 一体型 , 生体内診断 pp.969-977
Published Date 2008/5/25
DOI https://doi.org/10.11477/mf.1403101389
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 In this study, we used the integrated type EC (XCF-260EC1, Olympus, Tokyo, Japan). We classified the EC findings into 6 groups and investigated whether the classification was useful for the differential diagnosis. The subjects were 129 lesions from May, 2005 to October, 2007 which were firstly detected by an ordinary view, then stained with 1% methylene blue, and observed, using the EC view. EC 0a: uniform glands with round lumen, EC 0b: uniform glands with serrated lumen, EC 1a: uniform glands with slit-like lumen and faintly stained fusiform nuclei, EC 1b: uniform glands with enlarged and darkly stained nuclei. EC 2: irregularly shaped glands with enlarged and distorted nuclei. EC 3: destroyed gland structure with enlarged and distorted nuclei. The final pathological diagnosis was normal mucosa in 5 cases, hyperplastic polyp in 6 cases, low grade adenoma in 39 cases, high grade adenoma or minimally invasive cancer in 34, massively invasive cancer in 45 cases. Positive predictive value of each EC group was as follows. EC 0 (non-tumor): 100%. EC 1a: (low grade adenoma): 91.4%. EC 2 (high grade adenoma or invasive cancer): 88.9%. EC 3(invasive cancer): 97.4%. The integrated type EC system enabled us to observe colorectal lesions at the cellular level in vivo. Our new classification of EC images corresponded well with the final pathological diagnosis. Endocytoscopy was especially useful for differential diagnosis between neoplastic and non-neoplastic lesions.

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