Published online Apr 7, 2021. doi: 10.3748/wjg.v27.i13.1321
Peer-review started: December 31, 2020
First decision: January 27, 2021
Revised: January 29, 2021
Accepted: March 18, 2021
Article in press: March 18, 2021
Published online: April 7, 2021
The serrated neoplastic pathway is responsible for up to 20% of all sporadic colorectal cancers. Sessile serrated lesions (SSLs) should be accurately diagnosed and endoscopically removed.
Various findings have been proposed as features of SSLs. However, accurate diagnosis is often difficult.
This study developed a scoring system to predict the diagnosis of SSLs.
We retrospectively reviewed patients who underwent endoscopic resection at the Toyoshima Endoscopy Clinic. We collected data on 232 polyps that were endoscopically or pathologically diagnosed as serrated polyps. The significant factors for the diagnosis of SSLs were assessed using logistic regression analysis.
In the multivariate analyses, size (> 5 mm; P = 0.033), mucus cap (P = 0.005), and indistinct borders (P = 0.033) were independently associated with a diagnosis of SSL. The endoscopic SSL diagnosis score consisted of three features. An endoscopic SSL diagnosis score of 3 predicted pathological SSLs with 75% sensitivity, 80% specificity, and 78.4% accuracy.
Size (> 5 mm), mucus cap, and indistinct borders were significant endoscopic features for the diagnosis of SSL. Serrated polyps with these three features should be removed during colonoscopy.
A follow-up study is needed to verify the validity of the endoscopic SSL diagnosis score.