Algorithm for clarifying diagnostics and intraluminal endoscopic removal of colorectal epithelial neoplasms

Abstract

Aim: to work out of a set of measures aimed for early detection of colorectal tumors and the choice of a method of endoscopic surgery.Patients and methods: a multimodal approach was used, which included two successive stages: the stage of assessing the depth of invasion of malignant colorectal epithelial tumors (1) and the stage of endoscopic surgery. The study included 974 patients, aged 67 (43-81) years. The algorithm of the systemic automatic approach to differentiate the depth of invasion of superficial malignant colorectal tumors has been worked out based on analysis of color pictures of colonoscopy (Colonoscopy Video Analysis). The results of use of automatic system were compared with experts’ assessment.Results: the application of the developed algorithm of the systemic automatic approach to differentiate the depth of invasion of malignant ENC has high detection accuracy – the total average detection accuracy when implementing this algorithm is 72.02. No significant differences with experts’ assessment were obtained. With endoscopic removal of malignant tumors with superficial invasion, the correct selection of patients based on the tumor size (up to 2.0 and over 2.0 cm) and the corresponding removal technique (mucosal resection or endoscopic submucosal dissection) are decisive.Conclusion: the automatic system of evaluation of tumor invasion depth has a high accuracy and gives a possibility to exclude false positive results.