Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer
Background:Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal capilla...
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| Veröffentlicht in: | Gut 2008-01, Vol.57 (1), p.65-70 |
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| creator | East, J E Suzuki, N Stavrinidis, M Guenther, T Thomas, H J W Saunders, B P |
| description | Background:Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal capillaries and improves contrast for adenomas. This study examined whether a second pass with NBI in the proximal colon helped detect additional adenomas in patients with HNPCC.Methods:62 patients from HNPCC families (Amsterdam II or genetic criteria) attending for colonoscopic surveillance were examined twice from caecum to sigmoid–descending junction, first with high definition white light and then a second pass with NBI in a back-to-back fashion. All polyps detected were removed for histopathological analysis.Results:At least one adenoma in the proximal colon was detected during the initial white light pass in 17/62 (27%). NBI detected additional adenomas in 17/62 (27%). 26/62 (42%) patients had at least one adenoma detected after both white light and NBI; absolute difference 15% (95% CI 4–25%), p = 0.004 versus white light alone. The total number of adenomas increased from 25 before NBI to 46 after NBI examination, p |
| doi_str_mv | 10.1136/gut.2007.128926 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70159246</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>19528256</sourcerecordid><originalsourceid>FETCH-LOGICAL-b523t-3e31ecd426b666bee8be8f36c07d9e77aa4f10009af0d607b0efbd6dbf8ff9453</originalsourceid><addsrcrecordid>eNqF0U1v1DAQBmALgehSOHNDkRAckLK1E8cfRxTRgqjKBbhatjNevGTjYCfA_vs6zYpKXHrywc-Mx_Mi9JLgLSE1u9jN07bCmG9JJWTFHqENoUyUdSXEY7TBmPCy4VSeoWcp7THGQkjyFJ0RzkQuwxukbnSM4U9h9NAV_qB3ftgVLsTChj4MIdkwelukOf4G3_d6sFD4ofgBETo_6XgshjCUY-iPY0g-3VVFsJPuC7vg-Bw9cbpP8OJ0nqNvlx--th_L6y9Xn9r316Vpqnoqa6gJ2I5WzDDGDIAwIFzNLOadBM61po7kgaV2uGOYGwzOdKwzTjgnaVOfo7dr3zGGXzOkSR18srCMDGFOimPSyIqyByGRTSWqZoGv_4P7MMchf0IRzuUdq7O6WJWNIaUITo0xrzEeFcFqiUjliNQSkVojyhWvTn1nc4Du3p8yyeDNCehkde9iXqRP9y4_TQmV2ZWr82mCv__udfypGK95o26-t6qhoqWX7Wclsn-3enPYPzjlLfWctx0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1779952823</pqid></control><display><type>article</type><title>Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>East, J E ; Suzuki, N ; Stavrinidis, M ; Guenther, T ; Thomas, H J W ; Saunders, B P</creator><creatorcontrib>East, J E ; Suzuki, N ; Stavrinidis, M ; Guenther, T ; Thomas, H J W ; Saunders, B P</creatorcontrib><description>Background:Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal capillaries and improves contrast for adenomas. This study examined whether a second pass with NBI in the proximal colon helped detect additional adenomas in patients with HNPCC.Methods:62 patients from HNPCC families (Amsterdam II or genetic criteria) attending for colonoscopic surveillance were examined twice from caecum to sigmoid–descending junction, first with high definition white light and then a second pass with NBI in a back-to-back fashion. All polyps detected were removed for histopathological analysis.Results:At least one adenoma in the proximal colon was detected during the initial white light pass in 17/62 (27%). NBI detected additional adenomas in 17/62 (27%). 26/62 (42%) patients had at least one adenoma detected after both white light and NBI; absolute difference 15% (95% CI 4–25%), p = 0.004 versus white light alone. The total number of adenomas increased from 25 before NBI to 46 after NBI examination, p<0.001. The proportion of flat adenomas detected in the NBI pass, 9/21 (45%), was higher than in the white light pass, 3/25 (12%), p = 0.03. Including white light examination of the sigmoid and rectum, overall 28/62 (45%) patients had at least one adenoma detected.Conclusions:Use of NBI in the proximal colon for patients undergoing HNPCC surveillance appears to improve adenoma detection, particularly those with a flat morphology. NBI could help reduce interval cancer rates. ClinicalTrials.gov Identifier:NCT00313755.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gut.2007.128926</identifier><identifier>PMID: 17682000</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Adenoma - diagnosis ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Colonic Neoplasms - diagnosis ; Colonoscopy ; Colonoscopy - methods ; Colorectal cancer ; Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis ; Diagnosis, Differential ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Intubation ; Light ; Male ; Medical research ; Medical sciences ; Middle Aged ; Polyps ; Rectum ; Retreatment ; Sensitivity and Specificity ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surveillance ; Tumors</subject><ispartof>Gut, 2008-01, Vol.57 (1), p.65-70</ispartof><rights>2008 BMJ Publishing Group & British Society of Gastroenterology</rights><rights>2008 INIST-CNRS</rights><rights>Copyright: 2008 2008 BMJ Publishing Group & British Society of Gastroenterology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b523t-3e31ecd426b666bee8be8f36c07d9e77aa4f10009af0d607b0efbd6dbf8ff9453</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://gut.bmj.com/content/57/1/65.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://gut.bmj.com/content/57/1/65.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,23551,27903,27904,77346,77377</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19954149$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17682000$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>East, J E</creatorcontrib><creatorcontrib>Suzuki, N</creatorcontrib><creatorcontrib>Stavrinidis, M</creatorcontrib><creatorcontrib>Guenther, T</creatorcontrib><creatorcontrib>Thomas, H J W</creatorcontrib><creatorcontrib>Saunders, B P</creatorcontrib><title>Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer</title><title>Gut</title><addtitle>Gut</addtitle><description>Background:Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal capillaries and improves contrast for adenomas. This study examined whether a second pass with NBI in the proximal colon helped detect additional adenomas in patients with HNPCC.Methods:62 patients from HNPCC families (Amsterdam II or genetic criteria) attending for colonoscopic surveillance were examined twice from caecum to sigmoid–descending junction, first with high definition white light and then a second pass with NBI in a back-to-back fashion. All polyps detected were removed for histopathological analysis.Results:At least one adenoma in the proximal colon was detected during the initial white light pass in 17/62 (27%). NBI detected additional adenomas in 17/62 (27%). 26/62 (42%) patients had at least one adenoma detected after both white light and NBI; absolute difference 15% (95% CI 4–25%), p = 0.004 versus white light alone. The total number of adenomas increased from 25 before NBI to 46 after NBI examination, p<0.001. The proportion of flat adenomas detected in the NBI pass, 9/21 (45%), was higher than in the white light pass, 3/25 (12%), p = 0.03. Including white light examination of the sigmoid and rectum, overall 28/62 (45%) patients had at least one adenoma detected.Conclusions:Use of NBI in the proximal colon for patients undergoing HNPCC surveillance appears to improve adenoma detection, particularly those with a flat morphology. NBI could help reduce interval cancer rates. ClinicalTrials.gov Identifier:NCT00313755.</description><subject>Adenoma - diagnosis</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Colonic Neoplasms - diagnosis</subject><subject>Colonoscopy</subject><subject>Colonoscopy - methods</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Intubation</subject><subject>Light</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Polyps</subject><subject>Rectum</subject><subject>Retreatment</subject><subject>Sensitivity and Specificity</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surveillance</subject><subject>Tumors</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqF0U1v1DAQBmALgehSOHNDkRAckLK1E8cfRxTRgqjKBbhatjNevGTjYCfA_vs6zYpKXHrywc-Mx_Mi9JLgLSE1u9jN07bCmG9JJWTFHqENoUyUdSXEY7TBmPCy4VSeoWcp7THGQkjyFJ0RzkQuwxukbnSM4U9h9NAV_qB3ftgVLsTChj4MIdkwelukOf4G3_d6sFD4ofgBETo_6XgshjCUY-iPY0g-3VVFsJPuC7vg-Bw9cbpP8OJ0nqNvlx--th_L6y9Xn9r316Vpqnoqa6gJ2I5WzDDGDIAwIFzNLOadBM61po7kgaV2uGOYGwzOdKwzTjgnaVOfo7dr3zGGXzOkSR18srCMDGFOimPSyIqyByGRTSWqZoGv_4P7MMchf0IRzuUdq7O6WJWNIaUITo0xrzEeFcFqiUjliNQSkVojyhWvTn1nc4Du3p8yyeDNCehkde9iXqRP9y4_TQmV2ZWr82mCv__udfypGK95o26-t6qhoqWX7Wclsn-3enPYPzjlLfWctx0</recordid><startdate>20080101</startdate><enddate>20080101</enddate><creator>East, J E</creator><creator>Suzuki, N</creator><creator>Stavrinidis, M</creator><creator>Guenther, T</creator><creator>Thomas, H J W</creator><creator>Saunders, B P</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20080101</creationdate><title>Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer</title><author>East, J E ; Suzuki, N ; Stavrinidis, M ; Guenther, T ; Thomas, H J W ; Saunders, B P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b523t-3e31ecd426b666bee8be8f36c07d9e77aa4f10009af0d607b0efbd6dbf8ff9453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adenoma - diagnosis</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Colonic Neoplasms - diagnosis</topic><topic>Colonoscopy</topic><topic>Colonoscopy - methods</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Intubation</topic><topic>Light</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Polyps</topic><topic>Rectum</topic><topic>Retreatment</topic><topic>Sensitivity and Specificity</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surveillance</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>East, J E</creatorcontrib><creatorcontrib>Suzuki, N</creatorcontrib><creatorcontrib>Stavrinidis, M</creatorcontrib><creatorcontrib>Guenther, T</creatorcontrib><creatorcontrib>Thomas, H J W</creatorcontrib><creatorcontrib>Saunders, B P</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Science Journals</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>East, J E</au><au>Suzuki, N</au><au>Stavrinidis, M</au><au>Guenther, T</au><au>Thomas, H J W</au><au>Saunders, B P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2008-01-01</date><risdate>2008</risdate><volume>57</volume><issue>1</issue><spage>65</spage><epage>70</epage><pages>65-70</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><coden>GUTTAK</coden><abstract>Background:Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal capillaries and improves contrast for adenomas. This study examined whether a second pass with NBI in the proximal colon helped detect additional adenomas in patients with HNPCC.Methods:62 patients from HNPCC families (Amsterdam II or genetic criteria) attending for colonoscopic surveillance were examined twice from caecum to sigmoid–descending junction, first with high definition white light and then a second pass with NBI in a back-to-back fashion. All polyps detected were removed for histopathological analysis.Results:At least one adenoma in the proximal colon was detected during the initial white light pass in 17/62 (27%). NBI detected additional adenomas in 17/62 (27%). 26/62 (42%) patients had at least one adenoma detected after both white light and NBI; absolute difference 15% (95% CI 4–25%), p = 0.004 versus white light alone. The total number of adenomas increased from 25 before NBI to 46 after NBI examination, p<0.001. The proportion of flat adenomas detected in the NBI pass, 9/21 (45%), was higher than in the white light pass, 3/25 (12%), p = 0.03. Including white light examination of the sigmoid and rectum, overall 28/62 (45%) patients had at least one adenoma detected.Conclusions:Use of NBI in the proximal colon for patients undergoing HNPCC surveillance appears to improve adenoma detection, particularly those with a flat morphology. NBI could help reduce interval cancer rates. ClinicalTrials.gov Identifier:NCT00313755.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>17682000</pmid><doi>10.1136/gut.2007.128926</doi><tpages>6</tpages></addata></record> |
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| subjects | Adenoma - diagnosis Adult Aged Aged, 80 and over Biological and medical sciences Colonic Neoplasms - diagnosis Colonoscopy Colonoscopy - methods Colorectal cancer Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis Diagnosis, Differential Female Gastroenterology. Liver. Pancreas. Abdomen Humans Intubation Light Male Medical research Medical sciences Middle Aged Polyps Rectum Retreatment Sensitivity and Specificity Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surveillance Tumors |
| title | Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer |
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