Abstract
BackgroundAlthough type V pit pattern analysis is effective in determining the invasion depth of early colorectal cancers, the clinical results may vary because findings are operator-dependent. This study aimed to assess the benefits of type V pit pattern analysis in estimating the invasion depth using magnifying chromoendoscopy compared to that with conventional colonoscopy.MethodsA cross-sectional interpretation test involving 32 endoscopists with varying levels of experience performing colonoscopies was conducted. Fifty histopathologically diagnosed cases of intramucosal or submucosal cancer were selected retrospectively. The lesions were classified as superficial or deep by the endoscopists, based on magnifying chromoendoscopic and non-magnifying endoscopic images. The endoscopists were classified into 3 groups based on the number of colonoscopies performed: I (<500), II (501–5000), and III (>5000). Differences in the interpretation of invasion depth between group III and groups I and II were assessed using the Mann–Whitney U test.ResultsThere was no significant difference in the median number of correct interpretations using non-magnifying endoscopic images among the groups. However, a significant difference (P = 0.007) was observed between the results of groups III and I when the analysis was performed using magnifying chromoendoscopic images.ConclusionsWhen performed by less experienced endoscopists, pit pattern analysis of colonic lesions using magnifying chromoendoscopy is not a reliable modality for estimating invasion depth in early colorectal cancer.
Highlights
Type V pit pattern analysis is effective in determining the invasion depth of early colorectal cancers, the clinical results may vary because findings are operator-dependent
Type V pit patterns exhibit mild irregularity (VI mild), severe irregularity (VI severe), and non-structured (VN) patterns; in Japan, lesions showing VI severe and VN pit patterns are associated with a high risk of deep submucosal invasion [15,16]
For the first session, the number of correct interpretations of the invasion depth were 32.5 (30.5–35.5) in group I, 32.5 (29–34.5) in group II, and 34 (32–36.5) in group III; no significant differences were noted between group III and the other groups
Summary
Type V pit pattern analysis is effective in determining the invasion depth of early colorectal cancers, the clinical results may vary because findings are operator-dependent. This study aimed to assess the benefits of type V pit pattern analysis in estimating the invasion depth using magnifying chromoendoscopy compared to that with conventional colonoscopy. Magnifying chromoendoscopy has been widely demonstrated to be effective in differentiating between colorectal neoplastic and non-neoplastic lesions and in accurately diagnosing the invasion depth of early colorectal cancers [1-11]. Estimating invasion depth using magnifying endoscopy is considered more operator-dependent than differentiating between neoplastic and non-neoplastic lesions. Despite the demonstrated effectiveness of this technique, pit pattern analysis with magnifying endoscopy has not yet been widely accepted for the assessment of early colorectal cancers—especially in Western countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
