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World J Gastroenterol. Nov 14, 2026; 32(42): 120411
Published online Nov 14, 2026. doi: 10.3748/wjg.120411
Low accuracy and interobserver/intraobserver agreement for colorectal sessile serrated lesions: A multicenter diagnostic study
Hao Hu, Sheng-Bing Zhao, You-Dong Zhao, Xiang-Yu Sui, Song Zhang, Jia-Hui Wei, Xue-Fei Liu, Yu-Chuan Shi, Li Tang, Bing-Bing Zhang, Zhen Feng, Wei Cheng, Ming-Hua Zhu, Zhi Zhu, Zhao-Shen Li, Miao-Xia He, Yu Bai, Jing Zhang
Hao Hu, Xue-Fei Liu, Yu-Chuan Shi, Ming-Hua Zhu, Miao-Xia He, Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
Sheng-Bing Zhao, You-Dong Zhao, Xiang-Yu Sui, Song Zhang, Jia-Hui Wei, Zhao-Shen Li, Yu Bai, Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai 200433, China
Sheng-Bing Zhao, You-Dong Zhao, Xiang-Yu Sui, Song Zhang, Jia-Hui Wei, Zhao-Shen Li, Yu Bai, National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai 200433, China
Li Tang, Wei Cheng, Zhi Zhu, Jing Zhang, Department of Pathology, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
Bing-Bing Zhang, Department of Pathology, The 970th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Yantai 264001, Shandong Province, China
Zhen Feng, Department of Pathology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Co-first authors: Hao Hu and Sheng-Bing Zhao.
Co-corresponding authors: Yu Bai and Jing Zhang.
Author contributions: Hu H and Zhao SB conceptualized the study, designed the methodology, performed the formal analysis, wrote the original draft, and verified the underlying data, contributed equally to this work as co-first authors; Zhao YD, Sui XY, Zhang S, and Wei JH contributed to data curation, formal analysis, investigation, and writing-original draft; Liu XF, Shi YC, Tang L, Zhang BB, Feng Z, and Cheng W were responsible for data curation, resources, and validation; Zhu MH and Zhu Z provided resources and supervision; Li ZS and He MX acquired funding, administered the project, and supervised the study; Bai Y and Zhang J acquired funding, administered the project, supervised the study, and reviewed and edited the manuscript, contributed equally as co-corresponding authors; all authors have read and approved the final manuscript.
AI contribution statement: During the preparation of this manuscript, DeepSeek, the AI tool, was used for language translation and grammatical polishing as non-native English speakers. No AI tool was used for generate scientific ideas, research data, results, conclusions, or any figures/images. All AI-assisted text has been thoroughly reviewed, rewritten where necessary, and professionally edited. The authors take full responsibility for the final content of this paper. As non-native English speakers, we used DeepSeek only to help translate our original Chinese responses into English and to polish the language – mainly to ensure we used appropriate, respectful wording when addressing the reviewers’ comments. The scientific content, logic, rebuttal arguments, and all technical details in the “answering reviewers” file are completely our own. No AI was used to generate or alter the scientific responses themselves.
Supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project, No. 2023ZD0501601; the China National Postdoctoral Program for Innovative Talents, No. BX20230482; the Shanghai Eastern Talent Youth Program, No. QNWS2024100, No. QNWS2024108, and No. BJKJ2025002; the Chenguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission, No. 22CGA42; the Natural Science Foundation of Shanghai, No. 23ZR1478700; the Shanghai Sailing Program, No. 23YF1458600; the Special Clinical Research on Health Industry of Shanghai Municipal Health Commission, No. 20244Y0231; the Shanghai Medical Innovation Research Project, No. 23Y11902500; the Shenkang Diagnosis and Treatment Technology Promotion and Optimization Management Project, No. SHDC22025222 and No. SHDC22026216; the Naval Military Medical University General Incubation Fund, No. 2023MS038; the Naval Military Medical University Teaching Achievement Cultivation Project, No. JPY2025B11; the Naval Military Medical University Key Project on Teaching Reform, No. JYG2024A08; the Changhai Hospital Special Foundation for Clinical Research Program, No. 2024 LYB05; and the Changying Youth Seedling Plan.
Institutional review board statement: Ethical approval was obtained from the Ethics Committee of Changhai Hospital (No. CHEC2024-421).
Informed consent statement: The requirement for informed consent was waived by the Ethics Committee of Changhai Hospital because this retrospective study used de-identified archived specimens and posed no more than minimal risk to the subjects.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: The de-identified diagnostic data (the six pathologists’ reads per case) is available from the corresponding author at
zhangjing@smmu.edu.cn.
Corresponding author: Jing Zhang, MD, PhD, Department of Pathology, Changzheng Hospital, Naval Medical University, No. 415 Fengyang Road, Huangpu District, Shanghai 200003, China.
zhangjing@smmu.edu.cn
Received: February 26, 2026
Revised: April 18, 2026
Accepted: May 29, 2026
Published online: November 14, 2026
Processing time: 208 Days and 10.5 Hours
