Background and study aims: Chromoendoscopy in combination with magnifying endoscopy is useful in distinguishing
neoplastic from non-neoplastic colorectal polyps. Narrow band imaging (NBI) has been
developed as a new technique to differentiate tissue patterns in vivo. The aim of
the present study was to directly compare the diagnostic values of chromoendoscopy
and NBI for the differentiation of neoplastic from non-neoplastic colorectal polyps.
Patients and methods: In total, 200 colorectal polyps from 99 patients were distributed in a 1 : 1 ratio
in order to analyze the surface according to the pit pattern classification and vascular
patterns by either magnifying chromoendoscopy or NBI magnification. Histologic analysis
was performed on all lesions.
Results: Using the Kudo classification of mucosal patterns, NBI with magnification resulted
in a sensitivity of 90.5 % and a specificity of 89.2 % for the differentiation of
neoplastic vs. non-neoplastic lesions. This performance was comparable to magnifying
chromoendoscopy with a sensitivity of 91.7 % and a specificity of 90 %, respectively.
Using vascular patterns for differentiation, NBI with magnification correctly identified
93.7 % of neoplastic polyps and 89.2 % of non-neoplastic colorectal lesions, whereas
magnifying chromoendoscopy had a specificity of 95 % but a sensitivity of only 66.7
%.
Conclusion: NBI in combination with magnifying endoscopy is a promising tool for the differentiation
of neoplastic from non-neoplastic colorectal polyps in vivo without the necessity
of using dye. The detection of capillary vessels with NBI allows the evaluation of
colorectal lesions based on the vascular patterns with high diagnostic accuracy.
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C. Trautwein, MD
Medical Department III (Gastroenterology, Hepatology and Metabolic Diseases)
University Hospital Aachen
Pauwelsstr. 30
D-52074 Aachen
Germany
Fax: +49-241-80-82455
eMail: ctrautwein@ukaachen.de
