Chromoscopy may boost adenoma yield in Lynch syndrome

Last Updated: 2015-02-10

By David Douglas

NEW YORK (Reuters Health) - In patients with Lynch syndrome, colonoscopy with chromoscopy can detect adenomas that may be unseen with standard colonoscopy, according to French researchers.

As Dr. Christophe Cellier told Reuters Health by email, "Lynch syndrome is a genetic predisposition to colon cancer. Colonoscopy with adenomatous polyps resection may prevent, in part, the occurrence of these colorectal cancers. Small flat polyps may be missed by standard colonoscopy."

"In this prospective large study," he added, "we provide strong evidence for the use of chromendoscopy using carmine indigo in this subgroup of patients."

As reported online January 20 in the American Journal of Gastroenterology, Dr. Cellier, of Hôpital European Georges Pompidou, Paris, and colleagues studied 78 patients who were undergoing colonoscopy for screening or surveillance.

Standard colonoscopy was used first to detect visible lesions followed by colonoscopy with chromoscopy performed by a second gastroenterologist who was unaware of the first examiner's findings.

In all, 32 patients (41%) with at least one adenoma were identified by chromocolonoscopy, significantly more than the 18 (23%) found using the standard approach.

Of these patients with adenomas, 14 (44%) had at least one that was found only on the exam with chromoscopy. The mean number of adenomas detected per patient was 0.7 with chromocolonoscopy and 0.3 via the standard approach alone.

Given these findings, Dr. Cellier concluded that chromocolonoscopy "may allow a higher detection of adenomas and thus would probably allow a better prevention of colorectal cancer for these Lynch patients."

"We believe thus that this simple technique, even time-consuming, should be routinely performed for all Lynch patients during follow-up colonoscopy," he added.

This research was supported by the Programme Hospitalier de Recherche Clinique of the French Ministry of Health.

SOURCE: http://bit.ly/1y91dT6

Am J Gastroenterol 2015.