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Diagnostic features of sessile serrated adenoma/polyps on magnifying narrow band imaging: A prospective study of diagnostic accuracy
Author(s) -
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
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12688
Subject(s) - medicine , diagnostic accuracy , hyperplastic polyp , nice , stage (stratigraphy) , narrow band imaging , adenoma , prospective cohort study , radiology , pathology , colorectal cancer , endoscopy , colonoscopy , cancer , paleontology , biology , computer science , programming language
Background and Aims The narrow band imaging classification system ( NBI I nternational C olorectal E ndoscopic [ NICE ] classification) classifies colorectal polyps very accurately. However, sessile serrated adenoma/polyps ( SSA / P s) 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 / P s 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 / P s. We named these “expanded crypt openings” ( ECO s) and “thick and branched vessels” ( TBV s), 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 ECO s for SSA / P s were 84.3%, 81.1%, and 82.4%, whereas those of TBV s 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 ECO s, supplemented with TBV s, has high sensitivity for the diagnosis of SSA / P . These findings may facilitate the use of endoscopic optical diagnosis in clinical practice.