title: Diagnosis of sessile serrated adenomas/polyps using endocytoscopy (with videos).
abstract: Sessile serrated adenomas/polyps (SSA/P) are considered to be precursors of colorectal cancers. They therefore need to be distinguished from hyperplastic polyps, and should be treated similarly to adenomas. Various endoscopic classifications for discriminating SSA/P have recently been proposed and validated, including the 'Type II-O' pit pattern in magnifying chromoendoscopy and the 'varicose microvascular vessel' in narrow-band imaging. However, there is currently no diagnostic consensus on the endoscopic appearance of SSA/P. Endocytoscopy (EC) is an emerging modality with diagnostic potential for SSA/P. EC is a type of a contact light microscopy, which allows in vivo visualization of cells and nuclei facilitating precise, real-time pathological prediction. SSA/P show oval gland lumens with small round nuclei in EC, indirectly reflecting the pathological features. EC has shown a sensitivity of 83.3% and a specificity of 97.8% for the diagnosis of SSA/P. EC is also a promising tool for the diagnosis of SSA/P with cytological dysplasia because of its ability to detect morphological changes in nuclei, which is the most important factor determining the presence of dysplasia in the lesion. However, clinical data validating the usefulness of EC are lacking, and further studies are required.
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Wakamura
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Masashi
authors.initials: M
authors.lastname: Misawa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Takemasa
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Katagiri
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyachi
authors.affiliation: Digestive Disease Center, Showa University Koto-Toyosu Hospital.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, Hiroshima.
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.affiliation: Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D062048:Narrow Band Imaging / Q000379:methods*; D011230:Precancerous Conditions / Q000175:diagnosis*
keywords: colonoscopy; confocal endomicroscopy; optical biopsy; serrated lesion; ultra-magnifying endoscopy