OR12: Chromocolonoscopy with indigo carmine facilitates high adenoma detection in Lynch syndrome patients

Hüneburg1,4, P. van Heteren1,4, S. Aretz2,4, D. Pantelis3,4, C. Strassburg1,4, J.Nattermann1,4.

1 – Department of Internal Medicine I, University Hospital Bonn. 2 – Institute of Human Genetics, University Hospital Bonn. 3 – Department of Surgery, University Hospital Bonn. 4 – Center for Hereditary Tumour Syndromes, University Hospital Bonn.

Aim

The risk of colorectal cancer (CRC) in Lynch syndrome is up to 70% by the age of 70 years. Progression from adenoma to carcinoma is believed to be faster than in sporadic CRC. In a previous study, we demonstrated chromoendoscopy to significantly increase adenoma detection rate (ADR) compared to standard and NBI colonoscopy (28% vs. 15%). Here, we studied the diagnostic performance of chromoendoscopy in Lynch patients in daily clinical routine.

Method

Between 08/2006 and 02/2016 Lynch syndrome patients with a proven germline mutation in a mismatch repair gene were included. All patients were examined using pan-colonic chromoendoscopy with indigo carmine and high-definition endoscopes.

Results

A colonoscopy was performed in 152 patients with proven germline mutation (68 MLH1 (45%), 69 MSH2 (45%), 14 MSH6 (9%) und 1 EPCAM (1%)). Mean age was 45 years (+/- 12). In 84 patients (55%) a prior surgery due to CRC was documented. At least one adenoma was detected in 59 patients (38%). Hyperplastic polyp(s) were found in 70 patients (45%).

Conclusion

Chromoendoscopy is feasible and effective in routine care of Lynch syndrome patients.

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