Sa1591 The Diagnostic Ability of Micro Vascular Pattern Observed by Endocytoscopy

Tu1479 The Diagnostic Ability of Micro Vascular Pattern Observed by Endocytoscopy Masashi Misawa*, Shin-Ei Kudo, Kunihiko Wakamura, Hiroki Nakamura, Hiromasa Oikawa, Seiko Hayashi, Makoto Kutsukawa, Yuichi Mori, Toyoki Kudo, Kenta Kodama, Takemasa Hayashi, Hideyuki Miyachi, Yoshiki Wada Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan; Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Background and Aim: Endocytoscopy (EC) is an ultra-magnification technique, which can be performed to evaluate structural and cellular atypia with observation of lumens and nuclei in the surface layer of the mucosa[1, 2]. EC has made it possible to diagnose living tumor cells in vivo and to obtain an ultra-magnification pathological image simply by applying the scope to the target mucosa during an endoscopic examination. On the other hands, analysis of the surface microvessels of colorectal lesions using magnifying narrow-band imaging is useful for identifying the appropriate treatment method for colorectal lesions. In addition, the surface microvessels can be analyzed using EC. The aim of this study was to investigate whether the observation of surface microvessels using EC was useful in predicting the histopathology of colorectal lesions. Method: The study included 252 patients who underwent complete colonoscopy and endoscopic or surgical treatment between April 2006 and May 2013. A total of 315 lesions (13 normal mucosae, 16 hyperplastic polyps, 197 adenomas, and 89 submucosally invasive cancers) were retrospectively evaluated. The colonic surface micro-vascular patterns observed using EC were classified into the following 3 groups: EC-V1, the surface microvessels were obscure ; EC-V2, the surface microvessels were clearly observed, and their caliber and arrangement were uniform; and EC-V3, the surface microvessels were thick, and their caliber and arrangement were non-homogeneous. Result: The EC-V1 group included all the normal mucosae and hyperplastic polyps, whereas 90.5% (191/211) of EC-V2 lesions were adenomas and 95.9% (70/73) of EC-V3 lesions were invasive cancers. Conclusion: Vascular patterns of colorectal cancers observed by endocytoscopy were useful in predicting the histopathology of colorectal lesions. 1. Kudo, S. E., et al., Diagnosis of colorectal lesions with a novel endocytoscopic classification a pilot study. Endoscopy, 2011. 43(10): p. 869-75.2. Mori, Y., et al., Comprehensive diagnostic ability of endocytoscopy compared with biopsy for colorectal neoplasms: a prospective randomized noninferiority trial. Endoscopy, 2013. 45(2): p. 98-105. www.giejo Non-neoplastic urnal.org Adenoma Invasive cancer Total EC-V1 29 2 31 EC-V2 1 191 19 211 EC-V3 3 70 73 Total 30 196 89 315 Tu1480 CAP Assisted Colonoscopy (CAC) Is Associated With Increased Detection of Advanced Adenoma and Total Number of Polyps Per Patient in a Randomized Controlled Trial in a Predominantly Hispanic Population Mohamed O. Othman*, Mohamed Eloliby, Brian R. Davis, Richard Guerrero, Linda Sanchez, Alok Dwivedi, Luis a. Alvarado, Marc Zuckerman Internal Medicine/Gastroenterology, Texas Tech University HSC at El Paso, El Paso, TX Background: CAC has been reported to increase the Adenoma Detection Rate (ADR) in Asian populations. However, CAC trials in nonAsian populations have had conflicting results. We conducted a randomized controlled trial in our predominantly Hispanic population to investigate the effect of CAC on colonoscopy outcomes. Methods: This is a randomized controlled trial comparing CAC to Standard Colonoscopy (SC) in patients undergoing screening or surveillance colonoscopy. Randomization was done using sealed opaque envelopes. The study’s outcome variables included: Polyp Detection Rate (PDR), ADR, advanced adenoma detection rate, number of polyps per subjects, number of adenomas per subjects, cecal and terminal ileum (TI) intubation time and complication rates. The study’s variables were reported as means, standard deviation (SD) for continuous data and percentages for categorical data. Fisher’s exact test, and student t-test were used to compare baseline characteristics. Poisson regression analysis was used to estimate incidence rate ratio (IRR) of outcomes for CAC as compared with SC; p-values less than 5% were considered significant. Results: There was 440 patients were included in the study (88.5% Hispanics). Three attending gastroenterologists and one surgeon participated in the study. All attendings performed a minimum of 20 cases of CAC as a prerequisite to joining the study. There was no Vol difference between the two groups in gender, age, prior history of abdominal surgery , family history of colon cancer or type of colonoscope used (table 1). Cecal and TI intubation rates were similar in both groups (CAC: 97% and 86% vs. SC: 99% and 81% respectively). Cecal and TI intubation time (minutes) were similar in both groups (CAC: 5.4 and 7.1 vs ...