Optical Diagnosis of Sessile Serrated Polyps: Bottleneck for the Optical Diagnosis Paradigm?
Background: Optical diagnosis of diminutive (1 to 5 mm) polyps could result in a more cost-effective colonoscopy practice. Previous optical diagnosis studies did not incorporate the differentiation of sessile serrated polyps (SSPs). This study aimed to evaluate the impact of optical diagnosis of dim...
| Publicado en: | Journal of Clinical Gastroenterology Vol. 51; no. 5; pp. 426 - 433 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
May/Jun2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122399853&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122399853 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01920790 4BP jtl: Journal of Clinical Gastroenterology issn: 01920790 maglogo: N pubinfo: dt: May/Jun2017 vid: 51 iid: 5 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 122399853 122399853 NLM27775962 122399853 10.1097/MCG.0000000000000727 NLM27775962 122399853 ppf: 426 ppct: 7 formats: tig: atl: Optical Diagnosis of Sessile Serrated Polyps: Bottleneck for the Optical Diagnosis Paradigm? aug: au: Vleugels, Jasper L. A. IJspeert, Joep E. G. Hazewinkel, Yark van der Vlugt, Manon Fockens, Paul Koens, Lianne Dekker, Evelien affil: Department of Gastroenterology and Hepatology, University of Amsterdam, The Netherlands sug: subj: Colorectal Neoplasms Pathology Colonoscopy Adenomatous Polyps Pathology Colonic Polyps Pathology Predictive Value of Tests Aged Cross Sectional Studies Reproducibility of Results Middle Age Prospective Studies Female Male Hyperplasia Biopsy Colorectal Neoplasms Surgery Adenomatous Polyps Surgery Colonic Polyps Surgery Body Weights and Measures Human Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Background: Optical diagnosis of diminutive (1 to 5 mm) polyps could result in a more cost-effective colonoscopy practice. Previous optical diagnosis studies did not incorporate the differentiation of sessile serrated polyps (SSPs). This study aimed to evaluate the impact of optical diagnosis of diminutive SSPs on the overall performance of endoscopic polyp differentiation in daily colonoscopy practice.Methods: Endoscopy data were prospectively collected between 2011 and 2014 in a colonoscopy center. Each endoscopist reported a real-time optical diagnosis (SSP, adenoma or hyperplastic polyp) for all lesions in a structured colonoscopy reporting system, using narrow band imaging at their discretion. Study outcomes were accuracy of optical diagnosis, surveillance interval agreement and negative predictive value for diminutive rectosigmoid neoplastic histology based on the optical diagnosis of diminutive polyps compared to histopathology.Results: Of 2853 removed diminutive polyps, 202 (7.1%) were histologically proven SSPs. Optical diagnosis of diminutive SSPs was accurate in 24.4%. Diminutive SSPs determined 6.9% of postpolypectomy surveillance assignments. Inaccurate optical diagnosis of diminutive SSPs led to lower surveillance interval agreement (78.1% vs. 53.3%, P<0.01) and pooled negative predictive value per polyp (84.3% vs. 50.0%; P<0.01) in patients with diminutive SSPs when compared to patients without diminutive SSPs. Accurate endoscopic identification of diminutive SSPs improved from 0% in 2011 to 47% in 2014 (P=0.02).Conclusions: Endoscopic characterization of diminutive SSPs is difficult, impairing overall performance of optical diagnosis in patients with diminutive SSPs. Future optical diagnosis studies should use validated trainings and classification algorithms that include differentiation of SSPs. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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