Endoscopic Prediction of Advanced Histology in Diminutive and Small Colon Polyps

Aim & Methods: Endoscopic prediction of advanced histology (AH) is essential for selecting of polypectomy techniques and assessing the need of pathological confirmation. This study was aimed to assess the diagnostic power of predictors for AH in diminutive and small polyps. Adenomatous polyp (<10mm) removed endoscopically at single-center, were eligible. Two endoscopists reviewed endoscopic images to identify seven endoscopic findings: white-light imaging: redness, white spots, fold convergence, remarkable nodular changes; narrow-band imaging (NBI): circumferential brownish enhancement, heterogeneity in mucosal patterns; Magnified-NBI: typeIII (Sano-classification). Results: In 6170 polyps, 320 had AH, including five submucosal invasive cancers (SMI). Multivariate analysis showed heterogeneity, white spots, redness, NBI typeIII were significant predictors for AH. Using them, the sensitivity, specificity, and negative predictive value were 31.8%, 97.9%, and 96.3% (Table). All SMIs were successfully predicted. Conclusion: These predictors could help to identify high-risk lesions that require pathological evaluation in diminutive and small polyps.