Détection du cancer colorectal et des lésions prémalignes par chromoscopie et endoscopie à optique grossissante
Detection of colorectal cancer and pre-malignant conditions with chromo- and magnifying endoscopy
In Europe, colorectal cancer represents the second most frequent cause of tumour induced death. Survival and mortality of CRC can be improved by the detection of early cancers at a preclinical stage.
The newly developed high- resolution and magnification endoscopes offer features that allow more and new mucosal details to be seen. They are commonly used in conjunction with chromoendoscopy. The analysis of mucosal surface details is beginning to resemble histological examination. More accurate recognition of small flat and depressed neoplastic lesions is possible.
Nowadays commonly used stains in the colon are indigo carmine and methylene blue, which are applied via spraying catheter passed through the working channel of the endoscope. Various reports showed the possibility to predict neoplastic and non- neoplastic tissue by analysis surface architecture of the mucosa, which influences the endoscopic management.
In inflammatory bowel disease chromoendoscopy can be used for patients with long- standing ulcerative colitis to unmask flat intraepithelial neoplasias.
Chromoendoscopy holds promise for facilitating the endoscopic detection of neoplasia with targeted biopsies assisted by magnifying endoscopy. Differentiation of non- neoplastic from neoplastic lesions is possible with a high overall sensitivity and specificity. Chromoendoscopy with magnification will likely be the new standard method for surveillance colonoscopy in the near future.
A. HOFFMAN, M. JUNG, M.F. NEURATH, R. KIESSLICH
chromoendoscopy, flat and depressed lesions, magnifying endoscopes, pit pattern classification, ulcerative colitis