Magnifying colonoscopy : interobserver agreement in the assessment of colonic pit patterns and its correlation with histopathological findings

• Published in: International journal of colorectal disease Vol. 22; no. 11; pp. 1383 - 1388
• Main Authors: ANDRADE ZANONI, Esdras Camargo, CUTAIT, Raul, AVERBACH, Marcelo, REIS DE OLIVEIRA, Lix Alfredo, TEIXEIRA, Claudio Rolim, PIRES CORREA, Paulo Alberto Falco, PACCOS, José Luiz, ROSSINI, Giulio F, CAMARA LOPES, Luiz H
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-11-2007; Berlin Springer Nature B.V
• Subjects: Biological and medical sciences; Colon - pathology; Colonoscopy - methods; Digestive system. Abdomen; Endoscopy; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Observer Variation; Predictive Value of Tests; Sensitivity and Specificity; Performance evaluation; Human; Magnifying· Colonoscopy· Polyps,Diagnosis; Malignant tumor; Chromoendoscopy; Histopathology; Colonoscopy; Colon; Diagnosis; Endoscopy; Predictive factor; Magnification; Polyp
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-007-0336-5

Magnifying colonoscopy (MC) is recognized as an aid to the differential diagnosis between neoplastic and nonneoplastic lesions. This study evaluated interobserver agreement of experienced endoscopists in the assessment of colonic pit patterns through the Kudo's classification and correlated morphological aspects with histopathological findings.
A total of 213 magnification chromoendoscopic pictures of colonic lesions were collected from 161 consecutive patients and presented to three independent observers who expressed opinion about predominant pit pattern. All lesions were excised and sent for histopathological study.
Kappa statistics showed that the general agreement index with respect to the aspects of the pits was good among the three observers (0.561). Regarding prediction of histopathology according to the pit pattern diagnosis, overall accuracy was 84%, sensitivity was 91.4%, specificity was 67.2%, positive predictive value was 86.6%, and negative predictive value was 79.3%.
Although the interobserver reproducibility of the colonic pit pattern is good for experienced endoscopists, MC must not be used to replace the histopathological analysis, since it does not differentiate with the necessary safety neoplastic from nonneoplastic lesions.