Hattori Santa, Iwatate Mineo, Sano Wataru, Hasuike Noriaki, Kosaka Hidekazu, Ikumoto Taro, Kotaka Masahito, Ichiyanagi Akihiro, Ebisutani Chikara, Hisano Yasuko, Fujimori Takahiro, Sano Yasushi
Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
World J Gastrointest Endosc. 2014 Dec 16;6(12):600-5. doi: 10.4253/wjge.v6.i12.600.
To assess the risk of failing to detect diminutive and small colorectal cancers with the "resect and discard" policy.
Patients who received colonoscopy and polypectomy were recruited in the retrospective study. Probable histology of the polyps was predicted by six colonoscopists by the use of NICE classification. The incidence of diminutive and small colorectal cancers and their endoscopic features were assessed.
In total, we found 681 cases of diminutive (1-5 mm) lesions in 402 patients and 197 cases of small (6-9 mm) lesions in 151 patients. Based on pathology of the diminutive and small polyps, 105 and 18 were non-neoplastic polyps, 557 and 154 were low-grade adenomas, 18 and 24 were high-grade adenomas or intramucosal/submucosal (SM) scanty invasive carcinomas, 1 and 1 were SM-d carcinoma, respectively. The endoscopic features of invasive cancer were classified as NICE type 3 endoscopically.
The risk of failing to detect diminutive and small colorectal invasive cancer with the "resect and discard" strategy might be avoided through the use of narrow-band imaging observation with the NICE classification scheme and magnifying endoscopy.
评估采用“切除并丢弃”策略未能检测到微小和小的结直肠癌的风险。
在这项回顾性研究中招募了接受结肠镜检查和息肉切除术的患者。6名结肠镜检查医师使用NICE分类法预测息肉的可能组织学类型。评估微小和小的结直肠癌的发病率及其内镜特征。
我们总共在402例患者中发现681例微小（1 - 5毫米）病变，在151例患者中发现197例小（6 - 9毫米）病变。根据微小和小息肉的病理检查结果，105例和18例为非肿瘤性息肉，55�例和154例为低级别腺瘤，18例和24例为高级别腺瘤或黏膜内/黏膜下（SM）微浸润癌，分别有1例和1例为SM-d癌。浸润性癌的内镜特征在内镜下分类为NICE 3型。
通过使用带有NICE分类方案的窄带成像观察和放大内镜检查，可能避免采用“切除并丢弃”策略未能检测到微小和小的结直肠浸润性癌的风险。
