Pressure dye-spray: A simple and reliable method for differentiating adenomas from hyperplastic polyps in the colon

• Published in: Gastrointestinal endoscopy Vol. 55; no. 6; pp. 695 - 700
• Main Authors: Kanamori, Toshinari, Itoh, Makoto, Yoshimi, Naoki
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2002; Elsevier
• Subjects: Adenoma - pathology; Biological and medical sciences; Cohort Studies; Colonic Polyps - pathology; Colonoscopy; Coloring Agents; Diagnosis, Differential; Digestive system; Humans; Hyperplasia - pathology; Indigo Carmine; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Pressure; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Human; Dyes; Hyperplasia; Spraying; Adenoma; Differential diagnostic; Colonic disease; Colonoscopy; Digestive diseases; Intestinal disease; Endoscopy; Benign neoplasm; Colon; Polyp
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1067/mge.2002.123620

Background: Based on 10 years of experience with chromoendoscopy, our hypothesis was that colonic adenomas can be differentiated from hyperplastic polyps by use of a high-pressure spray-jet of dye (pressure dye-spray). To test the accuracy of pressure dye-spray, classification of colonic polyps as adenomas and hyperplastic polyps by pressure dye-spray and ordinary colonoscopic findings (shape, size, and color surface appearance) were compared. Methods: Pressure dye-spray chromoendoscopy was performed by using 0.035% indigo carmine, a spray-type cannula, and a water pump. Polyps were first classified as adenomas or hyperplastic polyps by ordinary colonoscopic findings. One or more pressure dye-spray bursts were then focused on the polyp from a distance of 1 to 2 cm. Polyps were classified as adenomas only if oozing of blood was evident; otherwise, they were classified as hyperplastic polyps. A histologic diagnosis was obtained for all polyps, and the results of ordinary colonoscopic findings and pressure dye-spray were compared. Results: This study examined 1468 polyps (1201 adenomas, 267 hyperplastic polyps; mean diameter 4 mm). The sensitivities for polyp differentiation with pressure dye-spray and ordinary colonoscopic findings were, respectively, 97.9% and 73.4% (p < 0.0001); specificities were, respectively, 96.6% and 92.1% (p = 0.077). Conclusions: Pressure dye-spray was found to be a reliable technique for differentiation between adenomas and hyperplastic polyps. (Gastrointest Endosc 2002;55:695-700.)