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Development of a narrow-band imaging classification to reduce the need for routine biopsies of gastric polyps

Gastroenterology Report 2021年第3期9卷 219-225,I0002页

作者： Ivor B.Asztalos caitlin a.colling Anna M.Buchner Vinay Chandrasekhara Department of Pediatrics Children’s Hospital of PhiladelphiaPhiladelphiaPAUSA Department of Internal Medicine Massachusetts General HospitalBostonMAUSA Division of Gastroenterology and Hepatology Hospital of the University of PennsylvaniaPhiladelphiaPAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA

Background Most incidental gastric polyps identified during upper endoscopy are considered ***,current guidelines recommend sampling all gastric polyps for histopathologic *** aimed to devise a simple narrow-band imaging(NBI)classification to reduce the need for routine biopsies of low-risk gastric *** Pairs of NBI and white-light images were collected from 73 gastric polyps for which concurrent histopathologic diagnosis was available.A diagnostic accuracy cohort study was *** blinded endoscopists independently analysed NBI features of each polyp for color,vessel pattern,surface pattern,and any combinations thereof to develop a classification scheme to differentiate low-risk polyps(fundic-gland or hyperplastic)from high-risk polyps(adenomatous or adenocarcinoma)and fundic-gland polyps(FGPs)from *** An isolated lacy vessel pattern and a homogenous absence of surface pattern successfully differentiated low-risk from high-risk gastric *** both descriptors into a single algorithm resulted in a negative predictive value(NPV)of 100%[95%confidence interval(CI):100%–100%],positive predictive value(PPV)of 13.7%(95%CI:2.6–24.8),sensitivity of 100%(95%CI:100%–100%),and specificity of 53.7%(95%CI:45.3%–62.0%)for high-risk *** would reduce the number of polyps requiring biopsy by 50%,while still capturing all high-risk *** FGPs,using a rule not to biopsy polyps with isolated lacy vessels resulted in a 94.9%NPV(95%CI:89.2%–100%),63.2%PPV(95%CI:47.2%–79.2%),94.8%sensitivity(95%CI:89.5%–100%),and 63.6%specificity(95%CI:51.3%–76.0%)for *** In this derivation cohort study,NBI is helpful for differentiating between high-risk and low-risk gastric polyps,thereby reducing the need for routine sampling of low-risk *** results need to be validated in a separate test population.

关键词： gastric polyps narrow-band imaging gastric cancer malignancy endoscopy

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