Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment

Yasutoshi Kobayashi, Shin Ei Kudo, Hideyuki Miyachi, Toshihisa Hosoya, Nobunao Ikehara, Kazuo Ohtsuka, Hiroshi Kashida, Shigeharu Hamatani, Shiro Hinotsu, Koji Kawakami

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: The number of patients suffering from colorectal cancer is increasing. According to Japanese guidelines, lesions with a submucosal invasive depth >1,000 μm should be treated with radical proctocolectomy. We propose and evaluate a new clinical classification for pit patterns that uses endoscopy to assess lesion depth for determination of the appropriate therapeutic approach for early colorectal cancers and adenomas. Methods: Endoscopic images of colorectal adenomas and early cancer cases with type V I pit pattern, resected surgically or endoscopically from April 2002 to April 2007 at Showa University Yokohama Northern Hospital, were utilized for analysis. Each image was retrospectively analyzed for (A) pit narrowness, (B) irregular pit margins, and (C) indistinct stromal staining. Sensitivity, specificity, and predictive value were evaluated as major outcomes, using pathological results as the standard. Result: In total, 186 cases were assessed. With all features considered (A, B, and C), the sensitivity, specificity, and positive and negative predictive values were 47.8%, 86.3%, 66.0%, and 74.2%, respectively. When limited to two features (A and B), these values were 75.3%, 81.2%, 70.2%, and 84.8%, respectively. Conclusion: Our results suggest that the established criteria can, to a certain degree, distinguish between high and low irregularity in colorectal lesions with V I pit pattern indicating submucosal cancer infiltration of more or less than 1,000 μm with the clinical consequence of surgery versus endoscopic mucosal resection/endoscopic mucosal dissection.

Original languageEnglish
Pages (from-to)1531-1540
Number of pages10
JournalInternational Journal of Colorectal Disease
Volume26
Issue number12
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

Fingerprint

Adenoma
Colorectal Neoplasms
Sensitivity and Specificity
Endoscopy
Dissection
Neoplasms
Guidelines
Staining and Labeling
Therapeutics
Endoscopic Mucosal Resection

Keywords

  • Clinical guideline
  • Colorectal cancer
  • Magnifying endoscopy
  • Pit pattern

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kobayashi, Y., Kudo, S. E., Miyachi, H., Hosoya, T., Ikehara, N., Ohtsuka, K., ... Kawakami, K. (2011). Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment. International Journal of Colorectal Disease, 26(12), 1531-1540. https://doi.org/10.1007/s00384-011-1246-0

Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment. / Kobayashi, Yasutoshi; Kudo, Shin Ei; Miyachi, Hideyuki; Hosoya, Toshihisa; Ikehara, Nobunao; Ohtsuka, Kazuo; Kashida, Hiroshi; Hamatani, Shigeharu; Hinotsu, Shiro; Kawakami, Koji.

In: International Journal of Colorectal Disease, Vol. 26, No. 12, 12.2011, p. 1531-1540.

Research output: Contribution to journalArticle

Kobayashi, Y, Kudo, SE, Miyachi, H, Hosoya, T, Ikehara, N, Ohtsuka, K, Kashida, H, Hamatani, S, Hinotsu, S & Kawakami, K 2011, 'Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment', International Journal of Colorectal Disease, vol. 26, no. 12, pp. 1531-1540. https://doi.org/10.1007/s00384-011-1246-0
Kobayashi, Yasutoshi ; Kudo, Shin Ei ; Miyachi, Hideyuki ; Hosoya, Toshihisa ; Ikehara, Nobunao ; Ohtsuka, Kazuo ; Kashida, Hiroshi ; Hamatani, Shigeharu ; Hinotsu, Shiro ; Kawakami, Koji. / Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment. In: International Journal of Colorectal Disease. 2011 ; Vol. 26, No. 12. pp. 1531-1540.
@article{c54d1abd02fe4f429502af310f025eb6,
title = "Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment",
abstract = "Background: The number of patients suffering from colorectal cancer is increasing. According to Japanese guidelines, lesions with a submucosal invasive depth >1,000 μm should be treated with radical proctocolectomy. We propose and evaluate a new clinical classification for pit patterns that uses endoscopy to assess lesion depth for determination of the appropriate therapeutic approach for early colorectal cancers and adenomas. Methods: Endoscopic images of colorectal adenomas and early cancer cases with type V I pit pattern, resected surgically or endoscopically from April 2002 to April 2007 at Showa University Yokohama Northern Hospital, were utilized for analysis. Each image was retrospectively analyzed for (A) pit narrowness, (B) irregular pit margins, and (C) indistinct stromal staining. Sensitivity, specificity, and predictive value were evaluated as major outcomes, using pathological results as the standard. Result: In total, 186 cases were assessed. With all features considered (A, B, and C), the sensitivity, specificity, and positive and negative predictive values were 47.8{\%}, 86.3{\%}, 66.0{\%}, and 74.2{\%}, respectively. When limited to two features (A and B), these values were 75.3{\%}, 81.2{\%}, 70.2{\%}, and 84.8{\%}, respectively. Conclusion: Our results suggest that the established criteria can, to a certain degree, distinguish between high and low irregularity in colorectal lesions with V I pit pattern indicating submucosal cancer infiltration of more or less than 1,000 μm with the clinical consequence of surgery versus endoscopic mucosal resection/endoscopic mucosal dissection.",
keywords = "Clinical guideline, Colorectal cancer, Magnifying endoscopy, Pit pattern",
author = "Yasutoshi Kobayashi and Kudo, {Shin Ei} and Hideyuki Miyachi and Toshihisa Hosoya and Nobunao Ikehara and Kazuo Ohtsuka and Hiroshi Kashida and Shigeharu Hamatani and Shiro Hinotsu and Koji Kawakami",
year = "2011",
month = "12",
doi = "10.1007/s00384-011-1246-0",
language = "English",
volume = "26",
pages = "1531--1540",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Springer Verlag",
number = "12",

}

TY - JOUR

T1 - Clinical usefulness of pit patterns for detecting colonic lesions requiring surgical treatment

AU - Kobayashi, Yasutoshi

AU - Kudo, Shin Ei

AU - Miyachi, Hideyuki

AU - Hosoya, Toshihisa

AU - Ikehara, Nobunao

AU - Ohtsuka, Kazuo

AU - Kashida, Hiroshi

AU - Hamatani, Shigeharu

AU - Hinotsu, Shiro

AU - Kawakami, Koji

PY - 2011/12

Y1 - 2011/12

N2 - Background: The number of patients suffering from colorectal cancer is increasing. According to Japanese guidelines, lesions with a submucosal invasive depth >1,000 μm should be treated with radical proctocolectomy. We propose and evaluate a new clinical classification for pit patterns that uses endoscopy to assess lesion depth for determination of the appropriate therapeutic approach for early colorectal cancers and adenomas. Methods: Endoscopic images of colorectal adenomas and early cancer cases with type V I pit pattern, resected surgically or endoscopically from April 2002 to April 2007 at Showa University Yokohama Northern Hospital, were utilized for analysis. Each image was retrospectively analyzed for (A) pit narrowness, (B) irregular pit margins, and (C) indistinct stromal staining. Sensitivity, specificity, and predictive value were evaluated as major outcomes, using pathological results as the standard. Result: In total, 186 cases were assessed. With all features considered (A, B, and C), the sensitivity, specificity, and positive and negative predictive values were 47.8%, 86.3%, 66.0%, and 74.2%, respectively. When limited to two features (A and B), these values were 75.3%, 81.2%, 70.2%, and 84.8%, respectively. Conclusion: Our results suggest that the established criteria can, to a certain degree, distinguish between high and low irregularity in colorectal lesions with V I pit pattern indicating submucosal cancer infiltration of more or less than 1,000 μm with the clinical consequence of surgery versus endoscopic mucosal resection/endoscopic mucosal dissection.

AB - Background: The number of patients suffering from colorectal cancer is increasing. According to Japanese guidelines, lesions with a submucosal invasive depth >1,000 μm should be treated with radical proctocolectomy. We propose and evaluate a new clinical classification for pit patterns that uses endoscopy to assess lesion depth for determination of the appropriate therapeutic approach for early colorectal cancers and adenomas. Methods: Endoscopic images of colorectal adenomas and early cancer cases with type V I pit pattern, resected surgically or endoscopically from April 2002 to April 2007 at Showa University Yokohama Northern Hospital, were utilized for analysis. Each image was retrospectively analyzed for (A) pit narrowness, (B) irregular pit margins, and (C) indistinct stromal staining. Sensitivity, specificity, and predictive value were evaluated as major outcomes, using pathological results as the standard. Result: In total, 186 cases were assessed. With all features considered (A, B, and C), the sensitivity, specificity, and positive and negative predictive values were 47.8%, 86.3%, 66.0%, and 74.2%, respectively. When limited to two features (A and B), these values were 75.3%, 81.2%, 70.2%, and 84.8%, respectively. Conclusion: Our results suggest that the established criteria can, to a certain degree, distinguish between high and low irregularity in colorectal lesions with V I pit pattern indicating submucosal cancer infiltration of more or less than 1,000 μm with the clinical consequence of surgery versus endoscopic mucosal resection/endoscopic mucosal dissection.

KW - Clinical guideline

KW - Colorectal cancer

KW - Magnifying endoscopy

KW - Pit pattern

UR - http://www.scopus.com/inward/record.url?scp=83655192086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=83655192086&partnerID=8YFLogxK

U2 - 10.1007/s00384-011-1246-0

DO - 10.1007/s00384-011-1246-0

M3 - Article

C2 - 21607587

AN - SCOPUS:83655192086

VL - 26

SP - 1531

EP - 1540

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

IS - 12

ER -