In hereditary nonpolyposis colorectal cancer flat and diminutive adenomas occur, particularly in the right colon.
Such lesions may assume a high risk of malignant transformation, and interval cancers are known to occur in this group.
Chromoscopic colonoscopy enhances detection in patients assuming a moderate to high lifetime risk of colorectal cancer.
Dr David Hurlstone and colleagues from England assessed the efficacy of high-magnification-chromoscopic colonoscopy.
The investigators assessed whether the technique detects neoplastic lesions in patients undergoing hereditary nonpolyposis colorectal cancer screening.
| Pan-colonic chromoscopy identified 52 lesions in 16 patients|
|American Journal of Gastroenterology|
The investigative team included 25 asymptomatic patients fulfilling modified Amsterdam criteria who underwent "back-to-back" colonoscopy.
Conventional colonoscopy with targeted chromoscopy was performed initially followed by pan-colonic chromoscopic colonoscopy.
The team controlled diagnostic extubation times and volumes of normal saline and indigo carmine.
Using conventional colonoscopy and targeted chromoscopy, the investigators detected 24 lesions in 13 patients.
The investigators found that pan-colonic chromoscopy identified a further 52 lesions in 16 patients.
Pan-chromoscopy identified significantly more adenomas than conventional colonoscopy and a significantly high number of flat adenomas.
Dr Hurlstone's team concluded, “Pan-colonic chromoscopic colonoscopy improves detection of significant neoplastic lesions in hereditary nonpolyposis colorectal cancer screening.”
“Pan-chromoscopy may help better stratify colorectal cancer "risk" in this cohort and aid planning of surveillance colonoscopic follow-up.”