Subset Analysis of a Multicenter, Randomized Controlled Trial to Compare Magnifying Chromoendoscopy with Endoscopic Ultrasonography for Stage Diagnosis of Early Stage Colorectal Cancer
Our recent prospective study found equivalent accuracy of magnifying chromoendoscopy (MC) and endoscopic ultrasonography (EUS) for diagnosing the invasion depth of colorectal cancer (CRC); however, whether these tools show diagnostic differences in categories such as tumor size and morphology remain...
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| creator | Yamada, Tomonori Shimura, Takaya Ebi, Masahide Hirata, Yoshikazu Nishiwaki, Hirotaka Mizushima, Takashi Asukai, Koki Togawa, Shozo Takahashi, Satoru Joh, Takashi |
| description | Our recent prospective study found equivalent accuracy of magnifying chromoendoscopy (MC) and endoscopic ultrasonography (EUS) for diagnosing the invasion depth of colorectal cancer (CRC); however, whether these tools show diagnostic differences in categories such as tumor size and morphology remains unclear. Hence, we conducted detailed subset analysis of the prospective data.
In this multicenter, prospective, comparative trial, a total of 70 patients with early, flat CRC were enrolled from February 2011 to December 2012, and the results of 66 lesions were finally analyzed. Patients were randomly allocated to primary MC followed by EUS or to primary EUS followed by MC. Diagnoses of invasion depth by each tool were divided into intramucosal to slight submucosal invasion (invasion depth |
| doi_str_mv | 10.1371/journal.pone.0134942 |
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In this multicenter, prospective, comparative trial, a total of 70 patients with early, flat CRC were enrolled from February 2011 to December 2012, and the results of 66 lesions were finally analyzed. Patients were randomly allocated to primary MC followed by EUS or to primary EUS followed by MC. Diagnoses of invasion depth by each tool were divided into intramucosal to slight submucosal invasion (invasion depth <1000 μm) and deep submucosal invasion (invasion depth ≥1000 μm), and then compared with the final pathological diagnosis by an independent pathologist blinded to clinical data. To standardize diagnoses among examiners, this trial was started after achievement of a mean κ value of ≥0.6 which was calculated from the average of κ values between each pair of participating endoscopists.
Both MC and EUS showed similar diagnostic outcomes, with no significant differences in prediction of invasion depth in subset analyses according to tumor size, location, and morphology. Lesions that were consistently diagnosed as Tis/T1-SMS or ≥T1-SMD with both tools revealed accuracy of 76-78%. Accuracy was low in borderline lesions with irregular pit pattern in MC and distorted findings of the third layer in EUS (MC, 58.5%; EUS, 50.0%).
MC and EUS showed the same limited accuracy for predicting invasion depth in all categories of early CRC. Since the irregular pit pattern in MC, distorted findings to the third layer in EUS and inconsistent diagnosis between both tools were associated with low accuracy, further refinements or even novel methods are still needed for such lesions.
University hospital Medical Information Network Clinical Trials Registry UMIN 000005085.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0134942</identifier><identifier>PMID: 26270341</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accuracy ; Cancer ; Clinical trials ; Colonoscopy ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - diagnosis ; Colorectal Neoplasms - diagnostic imaging ; Comparative analysis ; Diagnosis ; Diagnostic software ; Diagnostic systems ; Endoscopes ; Endoscopic ultrasonography ; Endoscopy ; Endosonography - methods ; Female ; Gastroenterology ; Hospitals ; Humans ; Lesions ; Lymphatic system ; Male ; Medical diagnosis ; Medical research ; Metabolism ; Morphology ; Neoplasm Invasiveness ; Patients ; Predictions ; Sensitivity and Specificity ; Studies ; Surgery ; Tumors ; Ultrasonic imaging ; Ultrasound ; University graduates</subject><ispartof>PloS one, 2015-08, Vol.10 (8), p.e0134942-e0134942</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Yamada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Yamada et al 2015 Yamada et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c1e0f95638a10035a327051e2f05adb5f9aa239262ce85b170d91d028aae4f1d3</citedby><cites>FETCH-LOGICAL-c692t-c1e0f95638a10035a327051e2f05adb5f9aa239262ce85b170d91d028aae4f1d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535886/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535886/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26270341$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Green, John</contributor><creatorcontrib>Yamada, Tomonori</creatorcontrib><creatorcontrib>Shimura, Takaya</creatorcontrib><creatorcontrib>Ebi, Masahide</creatorcontrib><creatorcontrib>Hirata, Yoshikazu</creatorcontrib><creatorcontrib>Nishiwaki, Hirotaka</creatorcontrib><creatorcontrib>Mizushima, Takashi</creatorcontrib><creatorcontrib>Asukai, Koki</creatorcontrib><creatorcontrib>Togawa, Shozo</creatorcontrib><creatorcontrib>Takahashi, Satoru</creatorcontrib><creatorcontrib>Joh, Takashi</creatorcontrib><title>Subset Analysis of a Multicenter, Randomized Controlled Trial to Compare Magnifying Chromoendoscopy with Endoscopic Ultrasonography for Stage Diagnosis of Early Stage Colorectal Cancer</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Our recent prospective study found equivalent accuracy of magnifying chromoendoscopy (MC) and endoscopic ultrasonography (EUS) for diagnosing the invasion depth of colorectal cancer (CRC); however, whether these tools show diagnostic differences in categories such as tumor size and morphology remains unclear. Hence, we conducted detailed subset analysis of the prospective data.
In this multicenter, prospective, comparative trial, a total of 70 patients with early, flat CRC were enrolled from February 2011 to December 2012, and the results of 66 lesions were finally analyzed. Patients were randomly allocated to primary MC followed by EUS or to primary EUS followed by MC. Diagnoses of invasion depth by each tool were divided into intramucosal to slight submucosal invasion (invasion depth <1000 μm) and deep submucosal invasion (invasion depth ≥1000 μm), and then compared with the final pathological diagnosis by an independent pathologist blinded to clinical data. To standardize diagnoses among examiners, this trial was started after achievement of a mean κ value of ≥0.6 which was calculated from the average of κ values between each pair of participating endoscopists.
Both MC and EUS showed similar diagnostic outcomes, with no significant differences in prediction of invasion depth in subset analyses according to tumor size, location, and morphology. Lesions that were consistently diagnosed as Tis/T1-SMS or ≥T1-SMD with both tools revealed accuracy of 76-78%. Accuracy was low in borderline lesions with irregular pit pattern in MC and distorted findings of the third layer in EUS (MC, 58.5%; EUS, 50.0%).
MC and EUS showed the same limited accuracy for predicting invasion depth in all categories of early CRC. Since the irregular pit pattern in MC, distorted findings to the third layer in EUS and inconsistent diagnosis between both tools were associated with low accuracy, further refinements or even novel methods are still needed for such lesions.
University hospital Medical Information Network Clinical Trials Registry UMIN 000005085.</description><subject>Accuracy</subject><subject>Cancer</subject><subject>Clinical trials</subject><subject>Colonoscopy</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - diagnosis</subject><subject>Colorectal Neoplasms - diagnostic imaging</subject><subject>Comparative analysis</subject><subject>Diagnosis</subject><subject>Diagnostic software</subject><subject>Diagnostic systems</subject><subject>Endoscopes</subject><subject>Endoscopic ultrasonography</subject><subject>Endoscopy</subject><subject>Endosonography - methods</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Lesions</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical 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Analysis of a Multicenter, Randomized Controlled Trial to Compare Magnifying Chromoendoscopy with Endoscopic Ultrasonography for Stage Diagnosis of Early Stage Colorectal Cancer</title><author>Yamada, Tomonori ; Shimura, Takaya ; Ebi, Masahide ; Hirata, Yoshikazu ; Nishiwaki, Hirotaka ; Mizushima, Takashi ; Asukai, Koki ; Togawa, Shozo ; Takahashi, Satoru ; Joh, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-c1e0f95638a10035a327051e2f05adb5f9aa239262ce85b170d91d028aae4f1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Accuracy</topic><topic>Cancer</topic><topic>Clinical trials</topic><topic>Colonoscopy</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - diagnosis</topic><topic>Colorectal Neoplasms - diagnostic imaging</topic><topic>Comparative analysis</topic><topic>Diagnosis</topic><topic>Diagnostic software</topic><topic>Diagnostic systems</topic><topic>Endoscopes</topic><topic>Endoscopic ultrasonography</topic><topic>Endoscopy</topic><topic>Endosonography - methods</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Lesions</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical research</topic><topic>Metabolism</topic><topic>Morphology</topic><topic>Neoplasm Invasiveness</topic><topic>Patients</topic><topic>Predictions</topic><topic>Sensitivity and Specificity</topic><topic>Studies</topic><topic>Surgery</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>University graduates</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamada, Tomonori</creatorcontrib><creatorcontrib>Shimura, Takaya</creatorcontrib><creatorcontrib>Ebi, Masahide</creatorcontrib><creatorcontrib>Hirata, 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamada, Tomonori</au><au>Shimura, Takaya</au><au>Ebi, Masahide</au><au>Hirata, Yoshikazu</au><au>Nishiwaki, Hirotaka</au><au>Mizushima, Takashi</au><au>Asukai, Koki</au><au>Togawa, Shozo</au><au>Takahashi, Satoru</au><au>Joh, Takashi</au><au>Green, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subset Analysis of a Multicenter, Randomized Controlled Trial to Compare Magnifying Chromoendoscopy with Endoscopic Ultrasonography for Stage Diagnosis of Early Stage Colorectal Cancer</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-08-13</date><risdate>2015</risdate><volume>10</volume><issue>8</issue><spage>e0134942</spage><epage>e0134942</epage><pages>e0134942-e0134942</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Our recent prospective study found equivalent accuracy of magnifying chromoendoscopy (MC) and endoscopic ultrasonography (EUS) for diagnosing the invasion depth of colorectal cancer (CRC); however, whether these tools show diagnostic differences in categories such as tumor size and morphology remains unclear. Hence, we conducted detailed subset analysis of the prospective data.
In this multicenter, prospective, comparative trial, a total of 70 patients with early, flat CRC were enrolled from February 2011 to December 2012, and the results of 66 lesions were finally analyzed. Patients were randomly allocated to primary MC followed by EUS or to primary EUS followed by MC. Diagnoses of invasion depth by each tool were divided into intramucosal to slight submucosal invasion (invasion depth <1000 μm) and deep submucosal invasion (invasion depth ≥1000 μm), and then compared with the final pathological diagnosis by an independent pathologist blinded to clinical data. To standardize diagnoses among examiners, this trial was started after achievement of a mean κ value of ≥0.6 which was calculated from the average of κ values between each pair of participating endoscopists.
Both MC and EUS showed similar diagnostic outcomes, with no significant differences in prediction of invasion depth in subset analyses according to tumor size, location, and morphology. Lesions that were consistently diagnosed as Tis/T1-SMS or ≥T1-SMD with both tools revealed accuracy of 76-78%. Accuracy was low in borderline lesions with irregular pit pattern in MC and distorted findings of the third layer in EUS (MC, 58.5%; EUS, 50.0%).
MC and EUS showed the same limited accuracy for predicting invasion depth in all categories of early CRC. Since the irregular pit pattern in MC, distorted findings to the third layer in EUS and inconsistent diagnosis between both tools were associated with low accuracy, further refinements or even novel methods are still needed for such lesions.
University hospital Medical Information Network Clinical Trials Registry UMIN 000005085.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26270341</pmid><doi>10.1371/journal.pone.0134942</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2015-08, Vol.10 (8), p.e0134942-e0134942 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Accuracy Cancer Clinical trials Colonoscopy Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - diagnosis Colorectal Neoplasms - diagnostic imaging Comparative analysis Diagnosis Diagnostic software Diagnostic systems Endoscopes Endoscopic ultrasonography Endoscopy Endosonography - methods Female Gastroenterology Hospitals Humans Lesions Lymphatic system Male Medical diagnosis Medical research Metabolism Morphology Neoplasm Invasiveness Patients Predictions Sensitivity and Specificity Studies Surgery Tumors Ultrasonic imaging Ultrasound University graduates |
| title | Subset Analysis of a Multicenter, Randomized Controlled Trial to Compare Magnifying Chromoendoscopy with Endoscopic Ultrasonography for Stage Diagnosis of Early Stage Colorectal Cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T08%3A17%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Subset%20Analysis%20of%20a%20Multicenter,%20Randomized%20Controlled%20Trial%20to%20Compare%20Magnifying%20Chromoendoscopy%20with%20Endoscopic%20Ultrasonography%20for%20Stage%20Diagnosis%20of%20Early%20Stage%20Colorectal%20Cancer&rft.jtitle=PloS%20one&rft.au=Yamada,%20Tomonori&rft.date=2015-08-13&rft.volume=10&rft.issue=8&rft.spage=e0134942&rft.epage=e0134942&rft.pages=e0134942-e0134942&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0134942&rft_dat=%3Cgale_plos_%3EA425311214%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1703926336&rft_id=info:pmid/26270341&rft_galeid=A425311214&rft_doaj_id=oai_doaj_org_article_20130e5b129c4ac1b178834a295b9218&rfr_iscdi=true |