[High resolution chromoendoscopy in the differential diagnosis of neoplastic and non-neoplastic polyps].
BACKGROUND
Magnifying colonoscopy brought the possibility of precise histologic diagnosis of colorectal lesions through their surface appearance. Despite the high accuracy of magnifying colonoscopy it is a specialized and expensive equipment not available in most medical centers. Due to these reasons the use of conventional colonoscopy with chromoscopy has been raised because this produce can reproduce most of the information previously obtained by magnifying colonoscopy.


OBJECTIVE
To determine the role of high resolution colonoscopy and indigo carmine chromoscopy for differential diagnosis between neoplastic and non-neoplastic colorectal lesions through measurements of accuracy, sensitivity, specificity, positive and negative predictive values. PATIENTS / METHODS: It was performed a prospective study. Seventy-four colorectal polyps were evaluated in 54 patients. A high resolution Olympus Exera CFQ 160L colonoscope was used. After the identification of the lesions, they were dyed with indigo carmine 0,2% and classified according to Kudo's classification by a single observer. After resection, the polyps were submitted to histopathological examination.


RESULTS
The endoscopic findings were compared to histopathologic results. The accuracy of the method was 79,7%, sensibility of 88,8%, specificity of 55%, positive predictive value of 84,2% and a negative predictive value of 64,7%.


CONCLUSIONS
We can conclude that we must be careful to apply high resolution colonoscopy and chromoscopy because adenomatous lesions can be misdiagnosed as non-neoplastic.
Averbach
Marcelo
M
Hospital Sírio Libanês, São Paulo, SP, Brazil.
Zanoni
Esdras Camargo A
EC
Corrêa
Paulo A F P
PA
Rossini
Giulio
G
Paccos
José Luiz
JL
Alencar
Marília L
ML
Câmara-Lopes
Luiz Heraldo
LH
Cutait
Raul
R
D018256:Adenomatous Polyps / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007203:Indigo Carmine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D004396:Coloring Agents; D007203:Indigo Carmine