Morphological features of colorectal sessile serrated adenoma/polyp under white light endoscopy and narrow band imaging
10.3969/j.issn.1007-1989.2017.12.014
- VernacularTitle:结直肠无蒂锯齿状腺瘤/息肉在白光内镜和 窄带成像模式下的形态特征
- Author:
Tian TIAN
1
;
Cui JING
;
Hu GUI-MING
;
Zhao ZHI-GUO
;
Cao ZHI-BO
;
Li HAO
Author Information
1. 郑州大学第二附属医院 消化内科
- Keywords:
sessile serrated adenoma/polyp;
hyperplastic polyp;
serrated adenoma;
narrow band imaging
- From:
China Journal of Endoscopy
2017;23(12):66-72
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) by white light endoscopy (WLE) and narrow band imaging (NBI). Methods A retrospective analysis was made on the morphological characteristics of SSA/P from January 2014 to March 2017, and compared with HP. Results There were 50 cases of SSA/P from 41 patients and 50 cases of HP from 43 patients. SSA/P located in the right colon was more than HP, but the difference was no statistical significance (16 cases vs 14 cases,P > 0.05). SSA/P have 11 cases of Type Is, 21 cases of Type IIa, 16 cases of Type IIb, 2 cases of Type LST, HP have 17 cases of Type Is, 25 cases of Type IIa, 8 cases of Type IIb, there was no significant difference (P > 0.05); SSA/P has more mucus than HP (37 cases vs 11 cases, P < 0.05). In NBI: The proportion of SSA/P with a red mucus cap, indistinctive borders, irregular shape, black dots inside the crypts, Cloud-like surface, Type II-O pit pattern and varicose microvascular vessels were higher than that of HP (P < 0.05). In the differential prediction of SSA/P and HP: Black dots inside the crypts (OR^ : 14.2; 95%CI: 5.8 ~ 34.7) with higher sensitivity, the sensitivity, specificity and accuracy respectively were 80.0%, 78.0%, 79.0%; Type II-O pit pattern (OR^ : 56.0; 95%CI: 17.7 ~ 177.6) with higher specificity, the sensitivity, specificity and accuracy respectively were: 70.0%, 96.0%, 83.0%; Red mucus cap (OR^ : 9.3; 95%CI: 3.8 ~ 22.8) with high specificity, the sensitivity, specificity and accuracy respectively were 64.0%, 80.0%, 74.0%; Cloud-like surface (OR^ : 16.9; 95%CI: 5.7 ~ 50.7) with high specificity and low sensitivity, the sensitivity, specificity and accuracy respectively were: 52.0%, 94.0%, 73.0%. Combining the black dots inside the crypts and Type II-O pit pattern with other endoscopic features of SSA/P could improve the sensitivity and the accuracy in diagnosis prediction. Conclusion The study has confirmed that SSA/P has unique endoscopic features compared with HP in NBI mode. Observing the morphological characteristics of SSA/P with NBI could achieve the purpose of identifying SSA/P and HP. The black dots inside the crypts and Type II-O pit pattern respectively have higher sensitivity and specificity in diagnosis prediction of SSA/P, so we recommend to combine the two indicators with others endoscopic features of SSA/P to identify SSA/P and HP to achieve the purpose of screening SSA/P in colonoscope examination.
