Background and Aims

There are limited data on the use of volumetric laser endomicroscopy (VLE) for imaging colon polyps. Our aim was to identify VLE features of colon polyps.

Methods

A total of 45 patients were included; 43 underwent endoscopic mucosal resection of colorectal polyps 2 cm or greater. These polyps were then scanned with VLE immediately after resection. Two patients who underwent partial colonic resection served as controls.

Results

Forty-three polyps were included with review of matching histology: 3 intramucosal cancer (IMCA), 5 tubular adenoma (TAs)/tubulovillous adenoma (TVA) with high-grade dysplasia (HGD), 9 TVA with only low-grade dysplasia (LGD), 5 serrated adenoma, and 21 TA with LGD. All TAs and TVAs were hyper-reflective compared with normal tissue. Effacement occurred in 82.4% (14/17) of the colonic polyps with advanced pathology (TVA with HGD/IMCA) compared with 11.6% (3/26) with non-advanced pathology (TA with LGD and serrated adenoma) (P < .0001). Forty-seven percent (8/17) of polyps with advanced pathology had greater than 5 glands on VLE compared with none in the non-advanced pathology group (P = .0001). An irregular surface mainly occurred in polyps with high-grade pathology (HGD/IMCA) versus TAs. Eighty-eight percent of polyps with HGD/IMC had an irregular surface (7/8) versus 6% (2/35) of TAs (P < .0001).

Conclusions

In this ex vivo clinicopathologic study, we show that there are distinct VLE features of colon polyps that may help identify polyps or features of a higher-grade lesion. This may have implications for possible in vivo application to aid in dysplasia or polyp detection.

中文翻译：

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结肠息肉的体积激光内镜检查特征与组织学相关性的鉴定

背景和目标

关于使用体积激光内窥镜检查（VLE）对结肠息肉进行成像的数据有限。我们的目的是确定结肠息肉的VLE特征。

方法

总共包括45名患者；43例行大肠息肉2 cm或更大的内镜黏膜切除术。切除后立即用VLE扫描这些息肉。两名接受结肠部分切除术的患者作为对照。

结果

纳入了43例息肉并进行了匹配的组织学检查：3例粘膜内癌（IMCA），5例具有高度不典型增生（HGD）的肾小管腺瘤（TAs）/结核性腺瘤（TVA），9例仅伴有低度不典型增生（LGD）的TVA ），5例锯齿状腺瘤和21例LGD患者。与正常组织相比，所有的TA和TVA都是高反射性的。出现病变的结肠息肉占82.4％（14/17）（高级伴TVA的HGD / IMCA），相比而言占11.6％（3/26）的非晚期病理（TAD伴LGD和锯齿状腺瘤）（P  <。 0001）。病理学进展的息肉中有47％（8/17）的VLE腺体大于5个，而非病理学高级的息肉中无一个（P = .0001）。与TA相比，不规则表面主要发生在具有高度病理（HGD / IMCA）的息肉中。患有HGD / IMC的息肉中有88％的TA表面不规则（7/8），而TAs的比例为6％（2/35）（P  <.0001）。

结论

在这项离体临床病理研究中，我们表明结肠息肉具有明显的VLE特征，可能有助于识别息肉或更高级别病变的特征。这可能暗示可能在体内应用以协助发育异常或息肉检测。