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Cold Snare Biopsy to Increase Diagnostic Accuracy in Patients With Suspected Colorectal Cancer Under Colonoscopy
Jinqing Wu1,2, Xue Li3
1Department of Gastroenterology, Fuyang People's Hospital, Fuyang, China.
Background And Aims:
Cold forceps biopsy (CFB) is commonly used for the suspected diagnosis of colorectal cancer (CRC). With larger pathologic specimens, cold snare biopsy (CSB) of CRC may be an attractive alternative. We performed a cohort study to compare the effectiveness and safety of CSB to CFB.
Methods:
Suspected CRC patients were retrospective and prospectively included and assigned to CFB or CSB at a single tertiary center. The primary outcome was the diagnostic consistency between endoscopic visual diagnosis and final biopsy tissue based on the duration required to determine diagnosis. And the diagnostic consistency between surgical postoperative pathology and final biopsy tissue. Secondary outcomes were clinically significant CSB or CFB-related bleeding, perforation, and technical success.
Results:
A total of 2000 suspected CRCs in 2000 patients were enrolled in CSB group (n=411) and CFB group (n=1589). The technical success rate of the 2 groups was 100%. Two groups were significantly different for diagnostic consistency: 411/411 (100.0%), 381/411 (92.7%) CSB versus CFB 1438/1589 (90.5%), 1388/1589 (87.35%) (OR 1.035 and 1.839; 95% CI: 1.026-1.045 and 1.233-2.744; P ＜0.001 and P = 0.002). Bleeding and perforation occurred similarly in the 2 groups (16/411, 2/411, 0/411, 0/411 vs. 73/1589, 11/1589, 0/1589, 0/1589; P ＞0.05).
Conclusions:
Compared with CFB, CSB is more effective in diagnosing suspected CRC without increasing adverse events.
