Differential Diagnosis of Colonic Neoplasm from Non-neoplasm (=5 mm) in Pit Pattern Observation by Conventional Colonoscopy Osamu Tsuruta 1,2 , Yuichiro Tsuji 1,2 , Hiroshi Kawano 1,2 , Mitsutake Fujita 1,2 , Atsushi Toyonaga 1,2 1Department of Medicine Ⅱ, Kurume University School of Medicine 2Division of Gastroenterology and Endoscopy, Kurume University School of Medicine Keyword: 通常内視鏡 , 色素内視鏡 , 拡大内視鏡 , pit pattern , 大腸腫瘍 pp.1613-1622
Published Date 1999/12/25
DOI https://doi.org/10.11477/mf.1403102891
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 Colonic pit pattern observation by conventional colonoscopy was performed on 411 lesions, sized less than 5 mm, to study its diagnostic ability to differentiate colonic neoplasm from non-neoplasm. Type of endoscope, dye-spray method and macroscopic type of lesion were also investigated for their effect on qualitative diagnostic accuracy.

 The following results were obtained:  1) Accurate diagnostic rates by CF-Q240I and CF-230I with the dye-spray contrast method were 82.2% and 87.7% respectively, while these rates were 59.0% and 60.3% without the dye-spray contrast method. Dye-spray contrast method was significantly effective (p<0.0001 and p<0.0005) in the differential diagnosis of neoplasms from non-neoplasms. However, no significant difference was noted between the results of the two types of endoscope.

 2) Accurate diagnostic rate was higher in neoplastic lesions than that in non-neoplastic lesions.

 3) Pit pattern on elevated type lesions was less well diagnosed than that on superficial type lesion.

 4) No significant difference in diagnostic accuracy was noticed between a magnifying colonoscope (CF-Q240Z) and a conventional colonoscope. To raise the diagnostic accuracy of the magnifying endoscope, dye-spray stain method (ex. pioctanine) was regarded as mandatory.

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