Patient selection: colorectal carcinoma on endoscopy
The endoscope used is an Olympus high resolution scope capable of magnifying by 75 times.
Parameters:
(1) surface pattern (regular or irregular) and type (tubular or papillary)
(2) avascular areas
(3) disrupted vessels
(4) thick vessels
|
Parameter
|
Finding
|
Points
|
|
surface pattern
|
regular and papillary
|
0
|
|
|
regular and tubular
|
1
|
|
|
irregular and papillary
|
3
|
|
|
irregular and tubular
|
5
|
|
avascular areas
|
absent
|
0
|
|
|
present
|
1
|
|
disrupted vessels
|
absent
|
1
|
|
|
present
|
3
|
|
thick vessels
|
absent
|
1
|
|
|
present
|
6
|
score for tumor grade =
= (points for surface pattern) + (points for avascular area)
score for invasion depth =
= (points for disrupted vessels) + (points for thick vessels)
Interpretation:
• minimum score for tumor grade: 0
• maximum score for tumor grade: 6
• minimum score for invasion depth: 2
• maximum score for invasion depth: 9
• A tumor score of 0 suggests an adenoma while a tumor score >= 1 suggests cancer.
• An invasion score of 9 indicates submucosal invasion >= 1,000 microns.
Performance:
• The tumor grade score has a sensitivity of 97% and specificity of 24%.
• The invasion score has a sensitivity of 56% and specificity of 100%.
