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- Title
Diagnostic features of sessile serrated adenoma/polyps on magnifying narrow band imaging: A prospective study of diagnostic accuracy.
- Authors
Yamashina, Takeshi; Takeuchi, Yoji; Uedo, Noriya; Aoi, Kenji; Matsuura, Noriko; Nagai, Kengo; Matsui, Fumi; Ito, Takashi; Fujii, Mototsugu; Yamamoto, Sachiko; Hanaoka, Noboru; Higashino, Koji; Ishihara, Ryu; Tomita, Yasuhiko; Iishi, Hiroyasu
- Abstract
Background and Aims The narrow band imaging classification system ( NBI International Colorectal Endoscopic [ NICE] classification) classifies colorectal polyps very accurately. However, sessile serrated adenoma/polyps ( SSA/ Ps) pathologically resembles hyperplastic polyp and has a possibility to be left in situ on NICE classification. The aim of this study was to establish and evaluate new simple diagnostic features for SSA/ Ps using magnifying narrow band imaging ( M-NBI). Methods We performed a single-arm observational study of diagnostic accuracy in two stages, as follows: seeking stage, development of simple diagnostic features for SSA/ P and definition of diagnostic criteria based on retrospective assessments of M- NBI; and validation stage, prospective validation and evaluation of the new diagnostic criteria. Results In the seeking stage, we identified brownish, oval, expanded crypt openings and thick-branched vessels on the surfaces of SSA/ Ps. We named these 'expanded crypt openings' ( ECOs) and 'thick and branched vessels' ( TBVs), respectively. In the validation stage, we enrolled 796 polyps in 261 patients, and classified 126 polyps as NICE type 1; all these lesions were endoscopically removed and assessed histopathologically. The sensitivity, specificity, and accuracy of ECOs for SSA/ Ps were 84.3%, 81.1%, and 82.4%, whereas those of TBVs were 45.1%, 68.9%, and 59.2%, respectively. M- NBI provided a sensitivity of 98% and specificity of 59.5% for discrimination of SSA/Ps from other lesions classified as NICE type 1. Conclusions Identification of ECOs, supplemented with TBVs, has high sensitivity for the diagnosis of SSA/ P. These findings may facilitate the use of endoscopic optical diagnosis in clinical practice.
- Subjects
ADENOMA; POLYPS; HISTOPATHOLOGY; ENDOSCOPY; SENSITIVITY analysis
- Publication
Journal of Gastroenterology & Hepatology, 2015, Vol 30, Issue 1, p117
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/jgh.12688