Abstract:
BACKGROUND AND STUDY AIMS:Patients with Lynch syndrome are at increased risk of developing small-bowel adenocarcinoma, which usually has a bad prognosis and needs to be diagnosed early. Our aim was to evaluate the yield of capsule endoscopy and CT enteroclysis in this situation. PATIENTS AND METHODS:We performed a prospective, blinded, comparative study of capsule endoscopy and CT enteroclysis in five academic centers. Thirty-five consecutive asymptomatic patients with Lynch syndrome, all with one proven deleterious mutation, were included. A double reading was performed blind for both types of examination. RESULTS:Histologically confirmed small-bowel neoplasms were diagnosed in three patients (8.6 %): one adenocarcinoma (T3N0M0) and two adenomas with low-grade dysplasia. Capsule endoscopy identified all neoplasms. CT enteroclysis raised suspicion of one neoplasm (adenocarcinoma) but missed the two others. Concordance between the two capsule readings was high with a κ value of 0.78 (95 %CI 0.55 to 1.0), which was not the case for CT enteroclysis, where the κ value was 0.15 (95 %CI -0.27 to 0.58). CONCLUSION:Curable early or advanced neoplasms in asymptomatic patients with Lynch syndrome using capsule endoscopy can be detected with a better reproducibility than with CT enteroclysis. The clinical usefulness of systematic small-bowel screening in these patients should be confirmed through large prospective studies.
journal_name
Endoscopyjournal_title
Endoscopyauthors
Saurin JC,Pilleul F,Soussan EB,Manière T,D'Halluin PN,Gaudric M,Cellier C,Heresbach D,Gaudin JL,Capsule Commission of the French Society of Digestive Endoscopy (SFED).doi
10.1055/s-0030-1255742subject
Has Abstractpub_date
2010-12-01 00:00:00pages
1057-62issue
12eissn
0013-726Xissn
1438-8812journal_volume
42pub_type
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