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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(01): E14-E21
DOI: 10.1055/a-1293-7086
Original article

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

Marco Bustamante-Balén
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Carla Satorres
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
David Ramos-Soler
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
3   Pathology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Maria García-Campos
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Noelia Alonso
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Marta Ponce
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Lidia Argüello-Viudez
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Francisco Giner
3   Pathology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Jaime Ferrer-Lozano
3   Pathology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
Vicente Pons-Beltrán
1   Gastrointestinal Endoscopy Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
2   Gastrointestinal Research Group, Health Research Institute (IISLaFe), Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Abstract

Background and study aims We aimed to describe the presence and combination of Hazewinkelʼs 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 Hazewinkelʼs 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, ≥ 10 mm, 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 > 5 mm 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 Hazewinkelʼs optical criteria are not reliable for a positive diagnosis of SSL, particularly for diminutive lesions.

Supplementary material



Publication History

Received: 02 June 2020

Accepted: 28 September 2020

Article published online:
01 January 2021

© 2021. 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/)

Georg Thieme Verlag KG
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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2021; 53(02): 213-213
DOI: 10.1055/a-1301-5892

 

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