Evaluation of the optical criteria for sessile serrated lesions of the colon: A prospective study on a colorectal cancer screening population.

Fecha de publicación: 01/01/2021 Fecha Ahead of Print: 01/01/2021

Autores de IIS La Fe

• Marco Bustamante Balén

  Autor

• Carla Satorres Paniagua

  Autor

• David Ramos Soler

  Autor

• María García Campos

  Autor

• Marta Ponce Romero

  Autor

• Lidia Argüello Viudez

  Autor

• Francisco Giner Segura

  Autor

• Jaime Ferrer Lozano

  Autor

• 

  Vicente Pons Beltrán

  Autor

Participantes ajenos a IIS La Fe

• Alonso, Noelia

Grupos

• Cirugía digestiva y Cuidados perioperatorios

  

  Leader

  Matteo Frasson

• Endoscopia Digestiva y Hepática

  

  Leader

  Vicente Pons Beltrán

Abstract

Background and study aims We aimed to describe the presence and combination of Hazewinkels optical diagnosis (OD) criteria for sessile serrated lesions (SSL), determining which lesion characteristics increase the probability of a correct OD, with a focus on diminutive lesions. Patients and methods This was a prospective study describing the presence of Hazewinkels OD criteria for SSL in lesions found in consecutive CRC screening colonoscopies. The presence of each OD criterion and their diagnostic combinations in SSL, related to the lesion's NBI International Colorectal Endoscopic (NICE) classification category, size, and location, were described. The presence of two or more optical criteria was considered diagnostic of SSL. The OD was compared to pathology as the gold standard. Results Seventy-nine SSLs (5.6%) were diagnosed. Cloud-like appearance was the most prevalent OD criterion (35, 44.3%). OD criteria were more frequently identified in NICE type 1, >= 10mm, and proximal lesions. Only 26 SLLs fulfilled the OD criteria (sensitivity 32.9%, 95% CI 29.1%-36.7%). The sensitivity for diminutive SSL was 14.7%, (95% CI 11.9%-17.6%). Eighty-five lesions were optically diagnosed as SSL. However, only in 26 SSL was this the definitive diagnosis (positive predictive value 30.6%, 95% CI 26.9%-34.3%). Size >5mm and proximal location increased the probability of a correct diagnosis. The overall accuracy of the optical criteria was 92.0% (95% CI, 89.8%-94.2%). Conclusions The Hazewinkels optical criteria are not reliable for a positive diagnosis of SSL, particularly for diminutive lesions.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords

• IMAGE-ENHANCED ENDOSCOPY; FEATURES; ADENOMAS/POLYPS; DIAGNOSIS; ADENOMA; COLONOSCOPY