Clin Colon Rectal Surg
DOI: 10.1055/s-0043-1770940
Review Article

Endoscopic Assessment of Colorectal Polyps

Jaron Pettis
1   Ochsner Clinic Foundation, Department of Colon and Rectal Surgery, New Orleans, Louisiana
,
Jennifer Paruch
1   Ochsner Clinic Foundation, Department of Colon and Rectal Surgery, New Orleans, Louisiana
› Author Affiliations

Abstract

Colorectal cancer is the third most common cancer among men and the second among women. In the United States alone, there are 150,000 cases diagnosed each year. Colonoscopy remains the best method for identifying, evaluating, and intervening on patients with precancerous lesions. Multiple guidelines and techniques are available to assist the endoscopist with accurate diagnosis of these lesions. These include the Paris, Narrow-Band Imaging (NBI) International Colorectal Endoscopic (NICE), Japan NBI Expert Team (JNET), Kudo, Hiroshima, and Shudo classifications which utilize techniques such as chromoendoscopy, narrow-band imaging, and endocytoscopy to evaluate pit pattern and surface morphology. Utilization of these tools can help the endoscopist predict the cytology of a colonic lesion and select the most appropriate method for resection while maximizing organ preservation.



Publication History

Article published online:
17 July 2023

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  • References

  • 1 Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin 2022; 72 (01) 7-33
  • 2 Siegel RL, Miller KD, Goding Sauer A. et al. Colorectal cancer statistics, 2020. CA Cancer J Clin 2020; 70 (03) 145-164
  • 3 Steele S, Hull TL, Hyman N, Maykel JA, Read TE, Whitlow CB. The Ascrs Textbook of Colon and Rectal Surgery. 4th ed. Springer Nature Switzerland AG 2022; 2022
  • 4 Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ 2014; 348: g2467
  • 5 The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 2003; 58 (6, Suppl): S3-S43
  • 6 Williams JG, Pullan RD, Hill J. et al; Association of Coloproctology of Great Britain and Ireland. Management of the malignant colorectal polyp: ACPGBI position statement. Colorectal Dis 2013; 15 (Suppl. 02) 1-38
  • 7 Halfter K, Bauerfeind L, Schlesinger-Raab A. et al. Colonoscopy and polypectomy: beside age, size of polyps main factor for long-term risk of colorectal cancer in a screening population. J Cancer Res Clin Oncol 2021; 147 (09) 2645-2658
  • 8 Sami SS, Subramanian V, Butt WM. et al. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus. Dis Esophagus 2015; 28 (08) 742-749
  • 9 Zimmermann-Fraedrich K, Groth S, Sehner S. et al. Effects of two instrument-generation changes on adenoma detection rate during screening colonoscopy: results from a prospective randomized comparative study. Endoscopy 2018; 50 (09) 878-885
  • 10 Rogart JN, Jain D, Siddiqui UD. et al. Narrow-band imaging without high magnification to differentiate polyps during real-time colonoscopy: improvement with experience. Gastrointest Endosc 2008; 68 (06) 1136-1145
  • 11 McGill SK, Evangelou E, Ioannidis JP, Soetikno RM, Kaltenbach T. Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics. Gut 2013; 62 (12) 1704-1713
  • 12 Rees CJ, Rajasekhar PT, Wilson A. et al. Narrow band imaging optical diagnosis of small colorectal polyps in routine clinical practice: the Detect Inspect Characterise Resect and Discard 2 (DISCARD 2) study. Gut 2017; 66 (05) 887-895
  • 13 Kudo S, Hirota S, Nakajima T. et al. Colorectal tumours and pit pattern. J Clin Pathol 1994; 47 (10) 880-885
  • 14 Tanaka S, Haruma K, Nagata S, Oka S, Chayama K. Diagnosis of invasion depth in early colorectal carcinoma by pit pattern analysis with magnifying endoscopy. Dig Endosc 2001; 13: S2-S5
  • 15 Hamada Y, Tanaka K, Katsurahara M. et al. Utility of the narrow-band imaging international colorectal endoscopic classification for optical diagnosis of colorectal polyp histology in clinical practice: a retrospective study. BMC Gastroenterol 2021; 21 (01) 336
  • 16 Wang Y, Li WK, Wang YD, Liu KL, Wu J. Diagnostic performance of narrow-band imaging international colorectal endoscopic and Japanese narrow-band imaging expert team classification systems for colorectal cancer and precancerous lesions. World J Gastrointest Oncol 2021; 13 (01) 58-68
  • 17 Hewett DG, Kaltenbach T, Sano Y. et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143 (03) 599-607.e1
  • 18 Sano Y, Tanaka S, Kudo SE. et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc 2016; 28 (05) 526-533
  • 19 Kobayashi S, Yamada M, Takamaru H. et al. Diagnostic yield of the Japan NBI Expert Team (JNET) classification for endoscopic diagnosis of superficial colorectal neoplasms in a large-scale clinical practice database. United European Gastroenterol J 2019; 7 (07) 914-923
  • 20 Wada Y, Kudo SE, Kashida H. et al. Diagnosis of colorectal lesions with the magnifying narrow-band imaging system. Gastrointest Endosc 2009; 70 (03) 522-531
  • 21 Takamaru H, Wu SYS, Saito Y. Endocytoscopy: technology and clinical application in the lower GI tract. Transl Gastroenterol Hepatol 2020; 5: 40
  • 22 Takeda K, Kudo SE, Mori Y, Misawa M, Kudo T, Wakamura K, Katagiri A, Baba T, Hidaka E, Ishida F, Inoue H, Oda M, Mori K. Accuracy of diagnosing invasive colorectal cancer using computer-aided endocytoscopy. Endoscopy 2017; 49 (08) 798-802 . Doi: 10.1055/s-0043-105486. Epub 2017 May 4. PMID: 28472832.
  • 23 Abad MRA, Shimamura Y, Fujiyoshi Y, Seewald S, Inoue H. Endocytoscopy: technology and clinical application in upper gastrointestinal tract. Transl Gastroenterol Hepatol 2020; 5: 28
  • 24 Spadaccini M, Iannone A, Maselli R. et al. Computer-aided detection versus advanced imaging for detection of colorectal neoplasia: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol 2021; 6 (10) 793-802