Published online Feb 7, 2016. doi: 10.3748/wjg.v22.i5.1869
Peer-review started: August 17, 2015
First decision: October 14, 2015
Revised: October 19, 2015
Accepted: November 9, 2015
Article in press: November 9, 2015
Published online: February 7, 2016
Processing time: 158 Days and 10.8 Hours
AIM: To study a new imaging equipment, high-resolution micro-endoscopy (HRME), in the diagnosis and pathological classification of colon polyps.
METHODS: We selected 114 specimens of colon polyps, 30 of which were colon polyps with known pathological types and 84 that were prospective polyp specimens; 10 normal colon mucosa specimens served as controls. We obtained images of 30 colon polyp specimens with known pathological types using HRME and analyzed the characteristics of these images to develop HRME diagnostic criteria for different pathological types of colon polyps. Based on these criteria, we performed a prospective study of 84 colon polyp specimens using HRME and compared the results with those of the pathological examination to evaluate the diagnostic value of HRME in the pathological classification of different types of colon polyps.
RESULTS: In the 30 cases of known pathological type of colon polyp samples, there were 21 cases of adenomatous polyps, which comprised nine cases of tubular adenoma, seven cases of villous adenoma and five cases of mixed adenomas. The nine cases of non-adenomatous polyps included four cases of inflammatory polyps and five cases of hyperplastic polyps five. Ten cases of normal colonic mucosa were confirmed pathologically. In a prospective study of 84 cases using HRME, 23 cases were diagnosed as inflammatory polyps, 11 cases as hyperplastic polyps, 18 cases as tubular adenoma, eight cases as villous adenoma and 24 cases as mixed adenomas. After pathological examination, 24 cases were diagnosed as inflammatory polyps, 11 cases as hyperplastic polyps, 19 cases as tubular adenoma, eight cases as villous adenoma and 22 cases as mixed adenomas. Compared with the pathological examinations, the sensitivities, specificities, accuracies, and positive and negative predictive values of HRME in diagnosing inflammatory polyps (87.5%, 96.7%, 94.0%, 91.3% and 95.1%), hyperplastic polyps (72.7%, 95.9%, 92.9%, 72.7% and 95.9%), tubular adenomas (73.7%, 93.8%, 89.3%, 77.8% and 92.4%), villous adenomas (75.0%, 97.4%, 95.2%, 75.0% and 97.4%), and mixed adenomas (75.0%, 93.3%, 88.1%, 81.8% and 90.3%) were relatively high.
CONCLUSION: HRME has a relatively high diagnostic value in the pathological classification of colon polyps. Thus, it may be an alternative to confocal microendoscopy in lower-resource or community-based settings.
Core tip: High-resolution micro-endoscopy (HRME) is a new imaging method for cytology imaging that can obtain real time pathological diagnosis. In this study, we determined the HRME diagnostic criteria for pathological types of colon polyps. According to the criteria, we performed a prospective study of the diagnostic value of colon polyps using HRME. The results showed that HRME has a relatively high diagnostic value in the pathological classification of colon polyps. This low cost microendoscopic technique might be an alternative to confocal microendoscopy in lower-resource or community-based settings.