eISSN  2234-2443
pISSN  2234-2400
Original Articles
  |   Clin Endosc_46_2_168_171.pdf
Clin Endosc. 2013 March;46(2):168-171.
Copyright ⓒ 2013 Clinical Endoscopy
Diagnostic Accuracy and Interobserver Agreement in Predicting the Submucosal Invasion of Colorectal Tumors Using Gross Findings, Pit Patterns, and Microvasculatures
Hye Jung Choi, Bo-In Lee, Hwang Choi, Kyu Yong Choi, Sang-Woo Kim, Joo Yong Song, Jeong Seon Ji and Byung-Wook Kim
Division of Gastroenterology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
Corresponding Author: Bo-In Lee , Tel: +82-32-280-5052 , Fax: +82-32-280-5987 , Email: gidoc4u@catholic.ac.kr
Background/Aims: Depth of invasion is one of the most important factors for establishing treatment strategy for colorectal tumors.
Methods: Three blinded experts reviewed electronic photos and video clips of 33 early colorectal cancer-like lesions. They estimated the depth of invasion based on conventional white light endoscopy (CWE), magnifying chromoendoscopy (MCE), and magnifying narrow band imaging endoscopy (MNE).
Results: The lesions included nine mucosal low-grade neoplasias, 16 mucosal high grade neoplasias, and eight carcinomas with invasion to the submucosal layer or beyond. The diagnostic accuracy for submucosal invasion by CWE ranged from 67% to 82%, while those by MCE and MNE ranged from 85% to 88% and 85% to 88%, respectively. The diagnostic accuracy significantly differed between CWE and MCE (p=0.034) and between CWE and MNE (p=0.039). The kappa values for CWE, MCE, and MNE among the endoscopists were 0.564, 0.673, and 0.673, respectively.
Conclusions: The estimation of submucosal invasion for early colorectal cancer-like lesions based on MCE or MNE is more accurate than CWE. MCE and MNE were demonstrated to have substantial agreement for predicting submucosal invasion.
Keywords: Colorectal neoplasms; Colonoscopy; Neoplasm staging
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