Accuracy Of Kudo’s Classification In Detecting Colorectal Neoplastic Polyps By The Use Of Magnifying Endoscopy

Background and Aim:Magnifying Endoscopy is a technique which permits the visualization of mucosal details that cannot be seen with standard endoscopy, it has the ability to enlarge the image upto150-fold magnification.Kudos Classification is based on pit patterns of mucosa, Type1to Type V and it is developed by Kudo et al.The aim of this study was to evaluate the sensitivity and specificity of Kudo pit pattern for the detection of neoplastic polyps by the help of magnifying endoscopy.Design:A Meta-Analysis. The Fixed Effects or Random Effects Model was used for sensitivity and specificity based on homogeneity and heterogeneity.Methods:A meta analytic study was done from January2012to august2012,Search was performed on Pubmed/Embase other databases and on internet. Total6Studies met inclusion criteria. A total of1697polyps were included in this meta-analysis. In all the studies colorectal polyps been identified by magnifying endoscopy and Pit pattern classification was done by using Kudo method and sensitivity specificity were calculated and compared with histopathology which is the Gold standard.Results:Six Eligible studies were added in which total1697colorectal lesions were identified for for the differentiation of neoplastic and non-neoplastic polyps. These Polyps were identified by using kudo pit pattern and then their biopsy samples were taken for histopathology. Using Kudo classification for all the studies of mucosal patterns with magnification resulted in a pooled sensitivity of (95%CI)0.92(0.90%to0.93%) and Pooled specificity of (95%CI)0.81(0.77%to0.84%). Sensitivities and specificities of all the studies were calculated individually and Fixed and Random effect Models were used for pooled sensitivity and pooled specificity respectively and the area under SROC curve was0.9632.Kudo classification of polyps is highly effective method in characterizing neoplastic colonic polyps. Conclusion:By determining Sensitivity and specificity of Pit Pattern for colorectal cancer with the use magnifying endoscope it is found that Kudos classification is a promising and accurate diagnostic method.Mucosal Pit pattern categorizing of neoplastic and non-neoplastic lesions (Type1,11,111,1V,V) makes it easier for the clinical practitioners to make decision about patient if endoscopic resection is required or not after type of lesion and depth of lesion is identified,usually Type1and Type11are non-neoplastic and Type111,1V,V are neoplastic. Type111and Type â…¤ are further classified into â…¢ s â…¡L and â…¤ into Vi â…¤N respectively. It also prevents patients to go from surgical procedure if its benign and small polyp Detection of pit pattern by magnifying endoscopy is not100%.