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Simple scoring system for the diagnosis of superficial non‐ampullary duodenal epithelial tumors
Author(s) -
Ishii Rindo,
Ohata Ken,
Sakai Eiji,
Takita Maiko,
Minato Yohei,
Muramoto Takashi,
Hashimoto Hirotsugu,
Morikawa Teppei,
Matsuhashi Nobuyuki
Publication year - 2021
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13762
Subject(s) - medicine , logistic regression , scoring system , adenoma , gastroenterology , adenocarcinoma , multivariate analysis , radiology , cancer
Background and Aims Differentiating superficial non‐ampullary duodenal epithelial tumors (SNADETs) that harbor malignant potential is important. We developed a simple scoring system and investigated whether it enables the differentiation of low‐grade adenoma and high‐grade adenoma/adenocarcinoma. Patients and Methods We retrospectively enrolled 197 consecutive patients with 207 SNADETs who underwent endoscopic resection at NTT Medical Center Tokyo between March 2016 and May 2019. Endoscopic findings were compared between Vienna Classification (VCL) C3 and C4/5 lesions. A multivariate logistic regression analysis was performed to develop a scoring system to identify VCL C4/5 lesions. The efficacy of our scoring system was elucidated among five novice and five expert endoscopists. Results Of 207 SNADETs, 66 and 141 lesions were pathologically diagnosed as VCL C3 and C4/5. A multivariate logistic regression analysis identified a tumor diameter of 10–19 mm (OR, 3.81; 95% CI, 1.02–14.2; P = 0.04), a tumor diameter ≥20 mm (OR, 95.2; 95% CI, 10.4–871.0; P < 0.001), a red color (OR, 14.5; 95% CI, 3.55–59.6; P < 0.001), the presence of irregular surface pattern (OR, 12.4; 95% CI, 3.00–51.4; P < 0.001), and the presence of irregular vessel pattern (OR, 13.7; 95% CI, 4.03–46.6; P < 0.001) as independent significant predictors of VCL C4/5. Considering these results, we developed a scoring system. Using an appropriate cutoff value, the diagnostic accuracy, sensitivity and specificity were calculated as 92%, 95% and 93%. The average diagnostic accuracy did not differ between novice and expert endoscopists (86% vs 87%, P = 0.76). Conclusions Our scoring system was useful for differentiating VCL C3 and C4/5 lesions. UMIN Clinical Trials (No. 000039063).