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Efficacy of magnifying chromoendoscopy for the differential diagnosis of colorectal lesions
Authors:Yasushi Sano  Yutaka Saito  Kuang‐I Fu  Takahisa Matsuda  Toshio Uraoka  Nozomu Kobayashi  Hiroaki Ito  Hirohisa Machida  Junko Iwasaki  Fabian Emura  Masao Hanafusa  Takayuki Yoshino  Shigeharu Kato  Takahiro Fujii
Abstract:Magnifying chromoendoscopy is an exciting new tool and offers detailed analysis of the morphological architecture of mucosal crypt orifices. In this review, we principally show the efficacy of magnifying chromoendoscopy for the differential diagnosis of colorectal lesions such as prediction between non‐neoplastic lesions and neoplastic ones, and distinction between endoscopically treatable early invasive cancers and untreatable cancers based on a review of the literature and our experience at two National Cancer Centers in Japan. Overall diagnostic accuracy by conventional view, chromoendoscopy and chromoendoscopy with magnification ranged from 68% to 83%, 82% to 92%, and 80% to 96%, respectively, and diagnostic accuracy of accessing the stage of early colorectal cancer using magnifying colonoscopy was over 85%. Although the reliability depends on the skill in magnifying observation, widespread applications of the magnification technique could influence the indications for biopsy sampling during colonoscopy and the indication for mucosectomy. Moreover, the new detailed images seen with magnifying chromoendoscopy are the beginning of a new period in which new optical developments, such as narrow band imaging system, endocytoscopy system, and laser‐scanning confocal microscopy, will allow a unique look at glandular and cellular structures.
Keywords:colorectal neoplasm  differential diagnosis  learning curve  magnifying chromoendoscopy  narrow band imaging (NBI)
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