Advances in endoscopy for colorectal polyp detection and classification

Abstract

While colonoscopy is considered the gold standard for colon cancer screening, recent advancements in endoscopes have allowed for improved visualization of the colonic mucosa and improved polyp detection rates. Newer technologies also allow for assessment of structural changes for polyp discrimination and determination of histologic type. Classification of polyps prevents the need for a histopathologic report, which requires the additional time and expertise of a pathologist and adds to the overall cost. This review considered advances in endoscopic technologies reported in PubMed over the past 12 years. Technologies that allow for increased visual field of colonic mucosa and may lead to improved colon polyp detection rates include cap-assisted colonoscopy, RetroView, extra-wide-angle view colonoscope, full-spectrum endoscopy, Third Eye Retroscope, NaviAid G-EYE balloon colonoscope, EndoRings, and Endocuff. Image-enhancing methods allow for pit pattern analysis of colorectal lesions, which enables the physician to classify colorectal polyps according to certain polyp characteristics. Image-enhancing methods include chromoendoscopy, autofluorescence, and virtual chromoendoscopy, including narrow band imaging, i-SCAN, flexible spectral imaging chromoendoscopy, and STORZ professional image enhancement systems. In addition, advancements have been made in in vivo microscopic evaluation of colonic epithelium, including confocal laser endomicroscopy, endocytoscopy, optical coherence tomography, spectroscopy, and autofluorescence spectroscopy. Colon capsule endoscopy also has a role in colon polyp detection and classification. The advancements in polyp detection and classification have great promise for earlier detection and removal of advanced adenomas before they advance to colorectal cancer. KEYWORDS Adenoma detection rates; colorectal polyp classification; colorectal polyp detection; endoscopic advances; in vivo microscopic evaluation; technological advancements C olorectal cancer (CRC) is the third most common cancer diagnosed in both men and women in the United States. Colonoscopy is the most widely accepted method for colon cancer screening and is currently considered the gold standard. Polypectomy is the most commonly performed therapeutic procedure to prevent progression to CRC. In a systematic review of six studies, the pooled miss rate with colonoscopy was 22% for polyps, 26% for adenomas <5 mm, and 13% for adenomas 5 to 10 mm. 1 There is substantial evidence suggesting that colonoscopy is less effective for right-sided than left-sided CRC. 2,3 Some reasons include worse bowel preparation in the right colon and the flat, less often

Lazer Taramalı Konfokal Mikroskobun Prensipleri ve Tıpta Kullanım Alanları

“…Konfokal lazer endomikroskobu; konfokal mikroskobunun, 1000x büyütme ile mikron düzeyinde uzamsal çözünürlük sağlayan düşük güçlü bir lazerle doku aydınlatmasına dayanan bir çeşididir. Kolorektal kanser ve premalin lezyonların hızlı bir şekilde saptanmasında kullanılır (32). Dokunun histopatolojisini yüksek duyarlılık ve doğrulukla tahmin ederken; neoplazmların non-neoplazmalardan, gelişmiş adenomların gelişmiş olmayan adenomlardan ve adenomatöz poliplerin adenomatöz olmayan poliplerden ayrılmasında kullanılır (33).…”

Targeted Nursing Combined with Endoscopic Submucosal Injection of Carbon Nanoparticles in the Treatment of Colorectal Cancer

“…However, this surgery fails to accurately locate the lesion under the laparoscope. Tumors of small size can be accurately located under the laparoscope by injecting carbon nanoparticles nearby the lesion via endoscopy [ 3 ]. Patients with colorectal cancer may develop negative emotions, and conventional nursing is ineffective in ameliorating their psychological status, resulting in compromised treatment compliance and quality of life [ 4 ].…”

Bioactive Components From Gracilaria rubra With Growth Inhibition on HCT116 Colon Cancer Cells and Anti-inflammatory Capacity in RAW 264.7 Macrophages

“…Colon cancer is the third most commonly diagnosed cancer in the United States ( 1 ). The etiology of colon cancer is associated with various factors that include genetics, diet, lifestyle, and the immune system.…”