Impact of virtual chromoendoscopy at colonoscopy: the final requiem for conventional histopathology?

摘要

At screening and surveillance colonoscopy, there are 2 major challenges: detection of colorectal lesions and differentiation between neoplastic and non-neoplastic tissue. Although histology of most of the larger polyps is easy to predict, reliable classification of small (5-9 mm) or diminutive (< 5 mm) lesions with standard imaging is often impossible. Yet, such small and diminutive polyps account for the majority of polyps (> 90%) that are detected during colonoscopy. The ability to reliably predict the histology of these polyps in vivo is appealing for several reasons. Although small, nondepressed, non-neoplastic polyps shouid be left in situ, lesions assessed as adenomatous should be resected. Nondepressed diminutive adenomas should even be disposed without histopathology, because they do not harbor significant risk of containing carcinoma.