Endoskopische Klassifikationen kolorektaler Polypen

Kernaussagen

• In der Detektion kolorektaler Adenome ist die Koloskopie der absolute Goldstandard.

• Die endoskopische Entfernung von kolorektalen Adenomen ist die mit Abstand effektivste Maßnahme in der Prävention des kolorektalen Karzinoms.

• Endoskopische Klassifikationen kolorektaler Polypen unter Anwendung virtueller Chromoendoskopietechniken (wie z. B. NBI) werden im endoskopischen Alltag zur Unterscheidung von neoplastischen und nicht neoplastischen Polypen sowie von resektablen und nicht resektablen Adenomen immer wichtiger.

• Die Anwendung der „Resect-and-Discard“-Strategie kann (noch) nicht generell empfohlen werden.

• Literatur

• 1 Kaminski MF, Regula J, Kraszewska E. et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010; 362: 1795-803
• 2 Jass JR. Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology 2007; 50: 113-130
• 3 Snover DC. Update on the serrated pathway to colorectal carcinoma. Hum Pathol 2011; 42: 1-10
• 4 Spring KJ, Zhao ZZ, Karamatic R. et al. High prevalence of sessile serrated adenomas with BRAF mutations: a prospective study of patients undergoing colonoscopy. Gastroenterology 2006; 131: 1400-1407
• 5 Young J, Jenkins M, Parry S. et al. Serrated pathway colorectal cancer in the population: genetic consideration. Gut 2007; 56: 1453-1459
• 6 [No authors listed]. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 2003; 58: 3-43
• 7 Uraoka T, Saito Y, Matsuda T. et al. Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum. Gut 2006; 55: 1592-1597
• 8 Saito Y, Uraoka T, Yamaguchi Y. et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections. Gastrointest Endosc 2010; 72: 1217-1225
• 9 Kahi CJ, Li X, Eckert GJ. et al. High colonoscopic prevalence of proximal colon serrated polyps in average-risk men and women. Gastrointest Endosc 2012; 75: 515-520
• 10 East JE, Vieth M, Rex DK. Serrated lesions in colorectal cancer screening: detection, resection, pathology and surveillance. Gut 2015; 64: 991-1000
• 11 Kahi CJ, Hewett DG, Norton DL. et al. Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy. Clin Gastroenterol Hepatol 2011; 9: 42-46
• 12 Kamiński MF, Hassan C, Bisschops R. et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2014; 46: 435-449
• 13 Kudo S, >Tamura S, Nakajima T. et al. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc 1996; 44: 8-14
• 14 Li M, Ali SM, Umm-a-OmarahGilani S. et al. Kudo’s pit pattern classification for colorectal neoplasms: A meta-analysis. World J Gastroenterol 2014; 20: 12649-12656
• 15 Oba S, Tanaka S, Sano Y. et al. Current status of narrow-band imaging magnifying colonoscopy for colorectal neoplasia in Japan. Digestion 2011; 83: 167-172
• 16 Testoni PA, Notaristefano C, Vailati C. et al. High-definition colonoscopy with i-Scan: Better diagnosis for small polyps and flat adenomas. World J Gastroenterol 2012; 18: 5231-5239
• 17 Hewett DG, Kaltenbach T, Sano Y. et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143: 599-607
• 18 Sumimoto K, Tanaka S, Shigita K. et al. Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Gastrointest Endosc 2016; [Epub ahead of print]
• 19 van den Broek FJ, van Soest EJ, Naber AH. et al. Combining autofluorescence imaging and narrow-band imaging for the differentiation of adenomas from non-neoplastic colonic polyps among experienced and non-experienced endoscopists. Am J Gastroenterol 2009; 104: 1498-1507
• 20 Parikh N, Perl D, Lee MH. et al. In vivo diagnostic accuracy of high resolution microendoscopy in differentiating neoplastic from non-neoplastic colorectal polyps: a prospective study. Am J Gastroenterol 2014; 109: 68-75
• 21 Yoshida N, Yagi N, Inada Y. et al. Ability of a novel blue laser imaging system for the diagnosis of colorectal polyps. Dig Endosc 2014; 26: 250-258
• 22 Ignjatovic A, East JE, Suzuki N. et al. Optical diagnosis of small colorectal polyps at routine colonoscopy (Detect InSpect ChAracterise Resect and Discard; DISCARD trial): a prospective cohort study. Lancet Oncol 2009; 10: 1171-1178
• 23 Ignjatovic A, Thomas-Gibson S, East JE. et al. Development and validation of a training module on the use of narrow-band imaging in differentiation of small adenomas from hyperplastic colorectal polyps. Gastrointest Endosc 2011; 73: 128-133
• 24 Patel SG, Schoenfeld P, Kim HM. et al. Real-time characterization of diminutive colorectal polyp histology using narrow-band imaging: implications for the resect and discard strategy. Gastroenterology 2016; 150: 406-418
• 25 Schachschal G, Mayr M, Treszl A. et al. Endoscopic versus histological characterisation of polyps during screening colonoscopy. Gut 2014; 63: 458-465
• 26 Rees CJ, Rajasekhar PT, Wilson A. et al. Narrow band imaging optical diagnosis of small colorectal polyps in routine clinical practice: the Detect Inspect Characterise Resect and Discard 2 (DISCARD 2) study. Gut 2016; [Epub ahead of print]
• 27 Denzer U, Beilenhoff U, Eickhoff A. et al. S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021-022. Z Gastroenterol 2015; 53: 1496-1530