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Endoscopic features of sessile serrated adenoma/polyps under narrowband imaging: A retrospective study
Author(s) -
Zhang Xin Tian,
Zhang Qing Wei,
Liu Fei,
Lin Xiao Lu,
Chen Jin Nan,
Li Xiao Bo
Publication year - 2019
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12706
Subject(s) - medicine , magnification , hyperplastic polyp , confidence interval , chromoendoscopy , receiver operating characteristic , polypectomy , narrow band imaging , odds ratio , gastroenterology , adenoma , colonoscopy , radiology , endoscopy , colorectal cancer , cancer , artificial intelligence , computer science
Objective Sessile serrated adenoma/polyps (SSA/P) are recognized as precancerous lesions in the colon and resemble hyperplastic polyps (HP). Definite endoscopic features under narrow band imaging (NBI) with or without magnification may help differentiate these two lesions. Our study aimed to identify specific endoscopic features of SSA/P by NBI. Methods A total of 199 patients with histopathologically proven colorectal SSA/P or HP after a polypectomy were enrolled. Magnifying and non‐magnifying NBI pictures of 206 matching lesions were evaluated by one expert and two non‐expert endoscopists using various endoscopic characteristics retrospectively. Results Multivariate analysis indicated that a clouded surface (odds ratio [OR] 6.48, 95% confidence interval [CI] 2.72‐15.44, P = 0.000) and dilated and branching vessels (DBV) (OR 7.95, 95% CI 3.71‐17.02, P = 0.000) were significant endoscopic features for diagnosing SSA/P compared with HP. The combination of these two features could improve diagnostic specificity to 96%, and the area under the receiver operating characteristic curve was 0.749. However, it seemed that the presence of dark spots (OR 1.93, 95% CI 0.94‐4.00, P = 0.075) was not a definite feature in differentiating these two lesions. Neither a mucus cap nor CP‐II meshed capillary vessels showed statistical significance in differentiating SSA/P from HP ( P = 0.590 and 0.293, respectively). Conclusions A clouded surface and DBV were two indicators for diagnosing SSA/P. Combining these two factors together under NBI with or without magnification achieved better diagnostic performance than when they were used alone.