The diagnostic value with analysis of pit pattern classificaion on early cancer of large intestine detection / 中华消化杂志

ABSTRACT

Objective To evaluate diagnostic value of pit pattern analysis on detection of early colorectal carcinoma. Methods 4176 patients were examined with colonoscopy and had the mucosal lesions stained with 0.4% indigo carmine, and part of them observed with magnifying endoscope and stereomicroscope, then compared the mucosal crypt patterns (the pit patterns Kudo classification) with pathologic diagnosis. Results There were 955 protruded and flat lesions on the large intestine mucosa in 752 patients, and among them there are 14 early cancers, 209 advanced cancers, 76Ⅱa、Ⅱb、Ⅱc、Ⅱa+Ⅱc lesions. We also found 43 laterally spreading tumors (LST) ranging from 16 to 110 mm in diameter, 2 for pit Ⅱ,18 for pit Ⅲ L, 19 for pit Ⅳ, 1 for pit Ⅴ A, 1 for Ⅴ N. The pit pattern of the most non neoplastic lesions was type Ⅰ or Ⅱ, which is about 85.4% (303/355), and the type of the adenomas was type Ⅲ or Ⅳ, about 86.0% (504/586). All the invasive carcinomas'pit patterns were type Ⅴ and there were 8 for type Ⅴ (2 Ⅴ A, 6Ⅴ N) among 14 early carcinomas. Conclusion Pit pattern analysis is a very important tool to determine the nature of lesions, which helps to decide the kinds of later therapeutic intervention.