Masayoshi Yamada1, Taku Sakamoto1, Yosuke Otake1, Takeshi Nakajima1, Aya Kuchiba2, Hirokazu Taniguchi3, Shigeki Sekine4, Ryoji Kushima3, Hemchand Ramberan5, Adolfo Parra-Blanco6, Takahiro Fujii7, Takahisa Matsuda1, Yutaka Saito1. 1. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. 2. Department of Biostatistics, National Cancer Center, Tokyo, Japan. 3. Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan. 4. Molecular Pathology Division, National Cancer Center Research Institute, Tokyo, Japan. 5. Department of Gastroenterology, University of Tennessee College of Medicine, Erlanger Hospital, Chattanooga, TN, USA. 6. Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. 7. TF Clinic, Tokyo, Japan.
Abstract
BACKGROUND: A sessile serrated adenoma/polyp (SSA/P) is a common type of colorectal polyp that possesses malignant potential. Although narrow-band imaging (NBI) can easily differentiate neoplastic lesions from hyperplastic polyps (HPs), SSA/Ps can be a challenge to distinguish from HPs. OBJECTIVE: To investigate specific endoscopic features of SSA/Ps by using NBI with optical magnification. DESIGN: Retrospective study. SETTING: Single high-volume referral center. PATIENTS: A total of 289 patients with histopathologically proven SSA/Ps or HPs obtained from colonoscopic polypectomy. INTERVENTION: Endoscopic images obtained by using NBI with optical magnification of 242 lesions (124 HPs, 118 SSA/Ps) removed between January 2010 and December 2012 were independently evaluated by 2 experienced endoscopists. Three external experienced endoscopists systematically validated the diagnostic accuracies by using 40 lesions (21 HPs and 19 SSA/Ps) removed between January and March 2013. MAIN OUTCOME MEASUREMENTS: Specific endoscopic features of SSA/Ps by using 5 potential characteristics: dilated and branching vessels (DBVs), irregular dark spots, a regular network pattern, a disorganized network pattern, and a dense pattern. RESULTS: Multivariate analysis demonstrated that DBV had a 2.3-fold odds ratio (95% confidence interval, 0.96-5.69) among SSA/Ps compared with HPs (sensitivity, 56%; specificity, 75%; accuracy, 65%). Interobserver and intraobserver agreement indicated almost perfect agreement for DBVs in both the evaluation and validation studies. When DBVs, proximal location, and tumor size (≥10 mm) were combined, the positive predictive value was 92% and the area under the curve was 0.783 in the receiver-operating characteristics by using the validation group. LIMITATIONS: Retrospective study. CONCLUSIONS: The current study suggests that a DBV is a potentially unique endoscopic feature of a colorectal SSA/P.
BACKGROUND: A sessile serrated adenoma/polyp (SSA/P) is a common type of colorectal polyp that possesses malignant potential. Although narrow-band imaging (NBI) can easily differentiate neoplastic lesions from hyperplastic polyps (HPs), SSA/Ps can be a challenge to distinguish from HPs. OBJECTIVE: To investigate specific endoscopic features of SSA/Ps by using NBI with optical magnification. DESIGN: Retrospective study. SETTING: Single high-volume referral center. PATIENTS: A total of 289 patients with histopathologically proven SSA/Ps or HPs obtained from colonoscopic polypectomy. INTERVENTION: Endoscopic images obtained by using NBI with optical magnification of 242 lesions (124 HPs, 118 SSA/Ps) removed between January 2010 and December 2012 were independently evaluated by 2 experienced endoscopists. Three external experienced endoscopists systematically validated the diagnostic accuracies by using 40 lesions (21 HPs and 19 SSA/Ps) removed between January and March 2013. MAIN OUTCOME MEASUREMENTS: Specific endoscopic features of SSA/Ps by using 5 potential characteristics: dilated and branching vessels (DBVs), irregular dark spots, a regular network pattern, a disorganized network pattern, and a dense pattern. RESULTS: Multivariate analysis demonstrated that DBV had a 2.3-fold odds ratio (95% confidence interval, 0.96-5.69) among SSA/Ps compared with HPs (sensitivity, 56%; specificity, 75%; accuracy, 65%). Interobserver and intraobserver agreement indicated almost perfect agreement for DBVs in both the evaluation and validation studies. When DBVs, proximal location, and tumor size (≥10 mm) were combined, the positive predictive value was 92% and the area under the curve was 0.783 in the receiver-operating characteristics by using the validation group. LIMITATIONS: Retrospective study. CONCLUSIONS: The current study suggests that a DBV is a potentially unique endoscopic feature of a colorectal SSA/P.
Authors: Sangeeta Jaiswal; Bishnu Joshi; Jing Chen; Fa Wang; Michael K Dame; Jason R Spence; Gina M Newsome; Erica L Katz; Yatrik M Shah; Sadeesh K Ramakrishnan; Gaoming Li; Miki Lee; Henry D Appelman; Rork Kuick; Thomas D Wang Journal: Antioxid Redox Signal Date: 2021-12-21 Impact factor: 8.401
Authors: Bishnu P Joshi; Zhenzhen Dai; Zhenghong Gao; Jeong Hoon Lee; Navin Ghimire; Jing Chen; Anoop Prabhu; Erik J Wamsteker; Richard S Kwon; Grace H Elta; Elena M Stoffel; Asha Pant; Tonya Kaltenbach; Roy M Soetikno; Henry D Appelman; Rork Kuick; D Kim Turgeon; Thomas D Wang Journal: Gastroenterology Date: 2016-12-22 Impact factor: 22.682