Assessment of rectal aberrant crypt foci by standard chromoscopy and its predictive value for colonic advanced neoplasms.
OBJECTIVE
Aberrant crypt foci (ACF) are thought to be preneoplastic lesions and are assessed by magnifying chromoscopy with methylene blue staining. The aim of this study was to evaluate the predictive value of rectal ACF recognized by conventional chromoscopy for colonic advanced neoplasms.


METHODS
Total colonoscopy, involving rectal chromoscopy using indigo carmine with standard colonoscopies, was performed on 386 patients. Patients who showed no ACF were classified as Grade 0, and those who had 1-4, 5-9, and 10+ ACF were classified as Grades 1, 2, or 3, respectively. The correlation between ACF grading and the prevalence of colonic advanced neoplasm, any adenoma>or=1 cm in size and/or with villous or tubulovillous morphology, and/or with high-grade dysplasia or invasive cancer, was assessed.


RESULTS
Sixty-three patients were classified as ACF Grade 0, 119 as Grade 1, 116 as Grade 2, and 88 as Grade 3. Colonic advanced neoplasm was observed in 4 patients (6.3%) for Grade 0, 43 (36.1%) for Grade 1, 61 (52.6%) for Grade 2, and 57 (64.8%) for Grade 3. As the ACF grade increased, the chance of a patient having a colonic advanced neoplasm increased. For multivariate analyses, compared with patients with Grade 0, those with Grades 1, 2, or 3 had a greater risk of colonic advanced neoplasm (odds ratio [OR] 9.18, 95% CI 3.08-27.33, OR 20.44, 95% CI 6.81-61.42, and OR 32.94, 95% CI 10.49-103.41, respectively).


CONCLUSIONS
Chromoscopic assessment of rectal ACF by conventional techniques is useful for predicting colonic advanced neoplasms.
Seike
Kazuhiro
K
Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Koda
Keiji
K
Oda
Kenji
K
Kosugi
Chihiro
C
Shimizu
Kimio
K
Nishimura
Masaki
M
Shioiri
Masanobu
M
Takano
Shigetsugu
S
Ishikura
Hiroshi
H
Miyazaki
Masaru
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D018450:Disease Progression; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011237:Predictive Value of Tests; D012007:Rectum / Q000473:pathology*
D004396:Coloring Agents; D008751:Methylene Blue