Clinical usefulness of magnifying colonoscopy for the diagnosis of ulcerative colitis‐associated neoplasia

Abstract

Background and Aim The aim of this investigation was to evaluate the efficacy of Japanese magnifying colonoscopic classifications for ulcerative colitis‐associated neoplasia (UCAN). Methods We reviewed the colonoscopy records from 2011 to 2018 at our institutions and identified cases of endoscopically or surgically resected UCAN observed by magnifying narrow‐band imaging (NBI) endoscopy and magnifying chromoendoscopy. Association between magnifying endoscopic classification and histopathological findings was investigated retrospectively. Japan NBI expert team (JNET) classification and pit pattern classification were applied. Results There were 17 patients who had a diagnosis of UCAN. Tumors of types 2A, 2B and 3 by JNET classification correlated with the histopathological findings of low‐grade dysplasia (LGD)/high‐grade dysplasia (HGD), HGD, and massively submucosal invasive (mSM) carcinoma, respectively. Tumors of types III/IV, VI low irregularity, and VI high irregularity/VN by pit pattern classification were correlated with the histopathological findings of LGD/HGD, HGD, and mSM carcinoma, respectively. Conclusions Japan NBI expert team classification and pit pattern classification may be predictive of the histological diagnosis and invasion depth of UCAN. This needs to be investigated prospectively in a large cohort or in a randomized clinical trial.

Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1

“…In our sub‐analysis, we showed that the strength of EC‐NBI was its time savings compared with EC staining and even biopsy. Our results are consistent with the concepts of conventional magnifying or non‐magnifying image‐enhanced endoscopy 30–32 . Recently, multiple biopsies from all segments of the colorectum have been recommended to evaluate a patient's inflammation severity and extent 33 .…”

Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance

“…The procedures carried out in our center used high‐definition endoscopes (Olympus 260/290 series), without the use of magnifying endoscopy. Magnifying endoscopy is a promising modality in the optical diagnosis of IBD lesions; however, we are unable to comment on the role of this technology in IBD surveillance. However, given that magnifying endoscopy is not in widespread in the West, our results are likely to reflect “real‐life” practice.…”

Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis

“…Of the 31 studies[ 5 , 13 - 42 ], 11 were retrospective [ 5 , 13 - 22 ], and 20 were prospective[ 23 - 42 ]. Seven studies[ 14 - 20 ] used the JNET classification alone, 21 studies[ 22 - 42 ] used the Pit pattern classification alone, and only 3 studies[ 5 , 13 , 21 ] used both the JNET and Pit pattern classifications in the same population. Thirteen studies[ 5 , 13 - 16 , 18 - 21 , 24 , 28 , 35 , 41 ] used narrow-band imaging magnifying endoscopy (NBI-ME), 13 studies used magnifying chromoendoscopy[ 22 , 25 - 27 , 29 , 30 , 32 - 35 , 37 , 38 , 42 ], and the other studies used BLI-magnification[ 17 , 23 ] ( n = 2), NBI[ 31 , 39 ] ( n = 2), and chromoendoscopy[ 36 , 40 ] ( n = 2).…”