Erkennung und Differenzierung kolorektaler Neoplasien

Zusammenfassung

Moderne endoskopische Technologie erlaubt die Diagnostik von frühen Neoplasien bis in den Millimeterbereich. Mithilfe von Intravitalfärbung, Hochauflösung und neuen Techniken (NBI, konfokale Lasermikroskopie etc.) können kleinste bösartige Veränderungen erkannt werden. Insbesondere flache Adenome und DALMs bei Colitis ulcerosa werden vermehrt diagnostiziert und lokal endoskopisch reseziert. Als Grundlage zur Diagnostik dient die Paris-Klassifikation zur morphologischen Charakterisierung und die Pit-pattern-Klassifikation zur endoskopischen Oberflächenanalyse.

Abstract

Modern endoscopic technology enables the diagnosis of early neoplasia of the colorectum up to few millimetres. By intravital staining, high resolution endoscopy and newly introduced techniques (narrow band imaging, confocal laser microscopy) even smallest malignant changes of the mucosa can be detected. In particular the number of flat adenoma and DALM's (dysplasia associated lesions and masses) in patients with chronic ulcerative colitis are increasingly diagnosed and locally treated by endoscopic resection. As a basis for specific diagnostic the Paris classification is helpful for morphological differentiation and the pit pattern classification for exact endoscopic analysis of the tumour surface.

Schlüsselwörter

kolorektale Neoplasie - flache Adenome - Koloskopie - Paris-Klassifikation - Pit-pattern-Klassifikation

Key words

colorectal neoplasia - flat adenoma - colonoscopy - Paris-classification - pit-pattern-classification

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