Sample Targeting Under Stereomicroscopy Can Raise The Detection Rate Of Early Colorectal Cancer

ObjectivesWe combined the application of magnifying encoscope, chromoendoscopy andexamination under the stereomicroscopy after the whole lump biopsy to explore if itcould raise the detection rates and accurate rate of precancerous lesion, minimumcancer and early stage cancer. of large intestine.To establish a set of standard pathological diagnosis method to raise thedetection rate of early colorectal cancer.Materials and MethodsThe colorectal tumor specimens which were resected by endoscopic mucosalresection (EMR) or endoscopic piecemeal mucosal resection (EPMR) in theNanfang Hospital from August 1 in 2004 to July 31 in 2006 were collected and thespecimens larger than 10 mm were observed under magnifying endoscope beforetreatment. We divided two group according to the different year. Experiment group:from August 1 in 2005 to July 31 in 2006, resected specimens, after EMR or EPMR,were observed under stereomieroscopy with cresyl violet dye staining to determine their pit patterns. The specimens which have the pit pattern associated with earlycolorectal cancer were chosen to examine and the suspicious part was confirmed byhistopathologic diagnosis. Other parts on the same specimen were chosen to doroutine pathological examination as a control, i.e control groupl. Control group 2:from August 1 in 2004 to July 31 in 2005, specimens were chosen to do routinepathological examination as homeochronous contrast. The results were comparedamong three groups. Two consultant histopathologists examined all specimensrespectively to comfirm the pathological diagnosis.Statistical analysis: SPSS10.0 is used as statistics analysis software. Thedifference have significance at the level of P＜=0.05. Pearson Chi-Square test wasused to analyze the sex and disease regions between two groups. Mann-Whitney Testwas used to analyzed the age and lesions size. McNemar Test was used to analyzedifference of diagnosis rate of early colorectal cancer between experiment group andcontrol group 1. Pearson Chi-Square was used to analyze difference of diagnosis rateof early colorectal cancer between experiment group and control group 2 and betweencontrol groups. Mann-Whitney Test was used to analyzed diagnosis rate of pitpattern under the endoscopy and stereomicroscopy.ResultsThis study enrolled 133 colorectal polyps in 23 patients (43 female, 80 male;mean age 49.65±1.76, range 1-80) in control group 2 from August 1 in 2004 to July31 in 2005. The size of the 133 lesions range from 10 to 50mm, mean 17.58±0.78mm.The size of the enrolled 126 colorectal polyps in 105 patients (29 female, 76 male;mean age 52.73±1.54, range 3-82) of experiment group, from August 1 in 2005 toJuly 31 in 2006, range from 10 to 80mm, mean 19.83±1.07mm. The comparison ofsex, age, size and disease regions between two groups was not considered statistically significant, P value is 0.235, 0.401, 0.122 and 0.195 respectively.126 cases were observed and 36 cases were confirmed to be early stagecarcinoma (including severe dysplasia) (36/126) in experiment group. And 30 caseswere diagnosed as mild or moderate dysplasia and only six case was confirmed to besevere dysplasia in the control group 1 (6/126, P＜0.01). The detection rate ofcontrol group 2 is 9.0% (12/133, P＜0.01). The diagnosis rate of early colorectalcancer was obviously higher than that of control groups.Conclusion1. It is difficult to observe the whole mount of specimens and do serial section onthem, and this will result in the improper diagnosis on the cancer. Our data suggeststhat sample targeting and localized biopsy under the stereomicroscopy can obviouslyraise the diagnosis rate of early colorectal cancer.2. We can differentiate neoplastic from non-neoplastic colorectal lesions throughobserve the pit pattern of mucosa.3. Established a set of standard pathological diagnosis method to raise thedetection rate of early colorectal cancer..