title: Further validation of magnifying chromocolonoscopy for differentiating colorectal neoplastic polyps in a health screening center.
abstract: OBJECTIVE
  The accuracy of conventional colonoscopy to differentiate neoplastic and non-neoplastic polyps is limited, justifying a biopsy for histologic analysis. Magnifying chromocolonoscopy has emerged as the best tool available for differentiating adenomatous and hyperplastic polyps during colonoscopy; however, magnifying endoscopes are rarely used in endoscopy units. This study aimed to further validate the effectiveness of magnifying chromocolonoscopy in the diagnosis of neoplastic colorectal polyps in a screening center.
  
  
  METHODS
  Five hundred average-risk subjects were randomly divided into two groups: a magnifying chromocolonoscopy group and a conventional chromocolonoscopy group, each of 250 subjects. Lesions were analyzed according to Kudo's classification of pit pattern (types I-V) and additionally subdivided into non-neoplastic (types I-II) and neoplastic (types III-V). Lesions judged as neoplastic were resected and those judged as non-neoplastic were left in situ. Only lesions < or =10 mm were included in the study. Resected lesions were analyzed with histopathological examination.
  
  
  RESULTS
  The overall accuracy of magnifying chromocolonoscopy for differentiating neoplastic lesions (95%, 135 of 142), was significantly higher than that of conventional chromocolonoscopy (84%, 102 of 122; P < 0.01). The accuracy of magnifying chromocolonoscopy for differentiating neoplastic lesions < or =5 mm was 94% (135 of 142), whereas that of conventional chromocolonoscopy was only 78% (69 of 89; P < 0.001). Results were not affected by the macroscopic types.
  
  
  CONCLUSIONS
  Magnifying chromocolonoscopy is superior to conventional chromocolonoscopy for the diagnosis of colorectal neoplastic lesions in the setting of a health testing center.
authors.affiliation: Division of Endoscopy, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Fabian
authors.initials: F
authors.lastname: Emura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Makoto
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujii
authors.forename: Kazumi
authors.initials: K
authors.lastname: Tagawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamakado
mesh_terms: D018256:Adenomatous Polyps / Q000473:pathology* / Q000601:surgery; D003111:Colonic Polyps / Q000473:pathology; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007203:Indigo Carmine; D007417:Intestinal Polyps / Q000473:pathology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012002:Rectal Diseases / Q000473:pathology*; D015203:Reproducibility of Results
chemical_list: D004396:Coloring Agents; D007203:Indigo Carmine