Tu1520 Implication of Image Enhanced Endoscopy and Short Training Program on the Morphological Diagnosis of Colorectal Neoplasm - An Asia-Pacific Multinational Study

Abstract

lesions ( 10mm, 17 HPs, 32 SSA/Ps, and 21 TSAs) that were subjected to AFI and NBI and consecutive endoscopic treatment were included in the present study. One-hundred and seventy-seven crypts of 38 serrated lesions (49 crypts of 10 HPs, 79 crypts of 17 SSA/Ps and 49 crypts of 11 TSAs) were analyzed. On AFI observation, 17.7% of HP, 37.5% of SSA/P and 79.0% of TSA had magenta color. When magenta color was used as a parameter in the differential diagnosis between HP and SSA/P, sensitivity, specificity and positive predictive value for AFI were 37.5%, 82.4% and 80.0%, respectively. On NBI observation, 0% of HP, 13.0% of SSA/P and 65.0% of TSA showed vascular dilatation. When vascular dilatation was used as a parameter in the differential diagnosis between HP and SSA/P, sensitivity, specificity and positive predictive value for NBI were 14.8%, 100% and 100%, respectively. The MIB-1 labeling index of the each zone was as follows; bottom zone (HP; 52.87%, SSA/P;53.02% and TSA; 41.60%), intermediate zone (HP; 14.35%, SSA/P; 24.65%, and TSA; 48.12%), and surface zone (HP;2.04%, SSA/P; 2.56%, and TSA; 18.29%). When compared with HP, proliferating cells in SSA/P were more frequently distributed in the intermediate zone. In addition, when compared with HP and SSA/P, proliferating cells in TSA were more frequently distributed in the intermediate and surface zones. Conclusions: This study clarified that TSA could be differentiated from HP or SSA/ P by using IEE and immunohistochemical staining. However, the differential diagnostic yields between HP and SSA/P with IEE were shown to be unsatisfactory. Biological malignant potential of SSA/P could be higher compared to HP as shown by MIB-1 stain. Therefore, endoscopic differential diagnostic criteria between HP and SSA/ P should be clarified as soon as possible.