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Randomised controlled trial comparing modified Sano's and narrow band imaging international colorectal endoscopic classifications for colorectal lesions

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World Journal of Gastrointestinal Endoscopy 2018年第9期10卷 210-218页

作者： Leonardo Zorrón Cheng Tao Pu Kuan Loong Cheong Doreen Siew Ching Koay sze pheh yeap Amanda Ovenden Mahima Raju Andrew Ruszkiewicz Philip W Chiu James Y Lau Rajvinder Singh Department of Gastroenterology Lyell McEwin Hospital Medical School University of Adelaide Department of Pathology Lyell McEwin Hospital Department of Surgery the Chinese University of Hong Kong

AIM To assess the utility of modified Sano′s(MS) vs thenarrow band imaging international colorectal endoscopic(NICE) classification in differentiating colorectal *** Patients undergoing colonoscopy between 2013 and 2015 were enrolled in this *** on the MS or the NICE classifications,patients were randomised for real-time endoscopic *** was followed by biopsies,endoscopic or surgical *** endoscopic diagnosis was then compared to the final(blinded) *** primary endpoint was the sensitivity(Sn),specificity(Sp),positive predictive value(PPV) and negative predictive value(NPV) of differentiating neoplastic and non-neoplastic polyps(MSⅡ/Ⅱo/Ⅲa/Ⅲb vs I or NICE 1 vs 2/3).The secondary endpoints were "endoscopic resectability"(MSⅡ/Ⅱo/Ⅲa vs Ⅰ/Ⅲb or NICE 2 vs 1/3),NPV for diminutive distal adenomas and prediction of post-polypectomy surveillance *** A total of 348 patients were *** Sn,Sp,PPV and NPV in differentiating neoplastic polyps from non-neoplastic polyps were,98.9%,85.7%,98.2% and 90.9% for MS;and 99.1%,57.7%,95.4% and 88.2% for NICE,*** area under the receiver operating characteristic curve(AUC) for MS was 0.92(95%CI:0.86-0.98);and AUC for NICE was 0.78(95%CI:0.69,0.88).The Sn,Sp,PPV and NPV in predicting "endoscopic resectability" were 98.9%,86.1%,97.8% and 92.5% for MS;and 98.6%,66.7%,94.7% and 88.9% for NICE,*** AUC for MS was 0.92(95%CI:0.87-0.98);and the AUC for NICE was 0.83(95%CI:0.75-0.90).The AUC values were statistically different for both comparisons(P = 0.0165 and P = 0.0420,respectively).The accuracy for diagnosis of sessile serrated adenoma/polyp(SSA/P) with high confidence utilizing MS classification was 93.2%.The differentiation of SSA/P from other lesions achieved Sp,Sn,PPV and NPV of 87.2%,91.5%,89.6% and 98.6%,*** NPV for predicting adenomas in diminutive rectosigmoid polyps(n = 150) was 96.6% and 95% with MS and NICE ***

关键词： Colorectal polyps Colorectal adenomas Colorectal neoplasm Colorectal lesions Randomised controlled trial Colonoscopy Magnifying colonoscopy Endoscopic imaging

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