title: Assessment of rectal aberrant crypt foci by standard chromoscopy and its predictive value for colonic advanced neoplasms.
abstract: 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.
authors.affiliation: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Seike
authors.forename: Keiji
authors.initials: K
authors.lastname: Koda
authors.forename: Kenji
authors.initials: K
authors.lastname: Oda
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Kimio
authors.initials: K
authors.lastname: Shimizu
authors.forename: Masaki
authors.initials: M
authors.lastname: Nishimura
authors.forename: Masanobu
authors.initials: M
authors.lastname: Shioiri
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Takano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishikura
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: 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*
chemical_list: D004396:Coloring Agents; D008751:Methylene Blue