| International Session (Workshop) 1 (JGES・JSGE) |
| Sat. November 3rd 9:00 - 12:00 Room 13: Kobe International Conference Center International Conference Room |
| Endoscopic factors which affect misdiagnosis in differentiation for neoplasms from non-neoplasms using magnifying NBI for colorectal lesions | |||
| Hiroki Nakamura1, Shin-ei Kudo1, Masashi Misawa1 | |||
| 1Showa University Northern Yokohama Hospital | |||
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| Background and aim ESGE guideline recommends that all polyps be resected except diminutive recto-sigmoid polyps that are predicted with high confidence to be hyperplastic. Therefore, it is important to diagnose whether it is non-neoplastic or neoplastic polyps. NBI is useful for lesion characterization. But in rare cases, there are difficult cases to differentiate non-neoplasms from neoplasms. We examined that cases of misdiagnosed adenoma(ADE) and hyperplastic polyp(HP) by JNET classification, and we extracted the endoscopic factors which affect misdiagnosis. Methods We assessed 820 lesions (ADE 714 cases, HP 96 cases) from Jan.2017 to Oct.2017. 40 lesions were misdiagnosed (14 ADE were classified as Type1, 26 HP were as Type2A). The exclusion criteria were following as: SSA/P, >10mm, had IBD. And we assessed the relationship between misdiagnosed case and following endoscopic factors.: (a)macroscopic morphology(flat or protruded), (b)size, (c)location, (d)color (brown or same), (e)vascular pattern (faint or network), (f)surface pattern (unclear or clear or clear with like light blue crest). Result When Type 1 as an indicator of HP, and Type 2A as ADE, overall sensitivity, specificity, accuracy was 75.9%, 98.0%,95.1%, respectively. In the case of Type 1 as ADE, there were few any cases when 3 experts looked back on polyps. But in the case of Type 2A as HP, there were a tendency of protruded type, size was less than 3mm, color was brown, vascular was network, surface pattern was clear with like light blue crest. Conclusion Differentiation of neoplasms or non-neoplasms by magnifying NBI is satisfactory, but we should remember that there are some non-neoplasms that mimic neoplasms. |
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Index Term 1: NBI Index Term 2: diminutive polyp |
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