Observational Study
Copyright ©The Author(s) 2018.
World J Gastroenterol. Dec 7, 2018; 24(45): 5179-5188
Published online Dec 7, 2018. doi: 10.3748/wjg.v24.i45.5179
Table 1 Baseline patient’s characteristics n (%)
Total number of lesions112
Mean age, years (SD)67.7 (10.1)
Sex ratio, % male57.1
Weight (Kg, SD)74.7 (15.4)
BMI (Kg/m2, SD)27.6 (5.1)
Family History of CRC27 (24.1)
Personal History of CRC7 (6.3)
Current smoking20 (17.9)
Diabetes19 (17.0)
Lesion size, mm (median, interquartile range)20 (14-30)
Categorical size
10-19 mm47 (42.0)
20-39 mm52 (46.4)
≥ 40 mm13 (11.6)
Location of the lesion
Cecum15 (13.4)
Ascending53 (47.3)
Transverse20 (17.9)
Descending4 (3.6)
Sigmoid10 (8.9)
Rectum10 (8.9)
ASA classification
ASA I18 (16.1)
ASA II56 (50.0)
ASA III38 (33.9)
Paris classification
0-Is48 (42.9)
0-IIa50 (44.6)
Other combinations (IIa + Is/IIc)14 (12.5)
NICE classification
NICE I17 (15.2)
NICE II94 (83.9)
NICE III1 (0.9)
Number of resected pieces
2-5 pieces46 (41.1)
> 5 pieces66 (58.9)
Baseline histology
Hyperplastic4 (3.6)
Adenoma with LGD53 (47.3)
Adenoma with HGD39 (34.8)
Sessile serrated adenoma (SSA)11 (9.8)
Traditional serrated adenoma (TSA)2 (1.8)
Adenocarcinoma (pT1 stage)3 (2.7)
Use of clips59 (52.7)
Clips per lesion (median, interquartile range)3 (1-3)
Use of clips
Prophylactic56 (94.9)
Intraprocedural bleeding2 (3.4)
Suspicion of deep mural injury1 (1.7)
Tattooed lesion after EPMR38 (33.9)
Endoscopist who performed piecemeal EMR
Expert endoscopists98 (87.5)
General gastroenterologists14 (12.5)
Median time to review (months, interquartile range)3.9 (3.0-5.3)
Table 2 Characteristics between groups at protocol study
WLE-NBI (n = 57)NBI-WLE (n = 55)P value
Sex (male, %)54.460.00.36
Age (yr)67.368.20.65
BMI (mean)28.227.00.23
Baseline polyp size0.002
10-19 mm16 (28.1)31 (56.4)
20-39 mm30 (52.6)22 (40.0)
≥ 40 mm11 (19.3)2 (3.6)
Location, right sided (%)79.078.20.92
Paris Classification0.34
0-Is26 (45.6)22 (40.0)
0-IIa22 (38.6)28 (50.9)
Other Combinations9 (15.8)5 (9.1)
NICE Classification0.90
NICE I8 (14.0)9 (16.4)
NICE II48 (84.2)46 (83.6)
NICE III1 (1.8)0 (0)
Baseline histology0.78
Hyperplastic2 (3.5)2 (3.6)
Adenoma with LGD26 (45.6)27 (49.1)
Adenoma with HGD22 (38.6)17 (30.9)
Sessile Serrated Adenoma (SSA)5 (8.8)6 (10.9)
Traditional serrated adenoma0 (0)2 (3.6)
Adenocarcinoma (pT1 stage)2 (3.5)1 (1.8)
Morphology of scar on site 10.12
Flat29 (50.9)20 (36.4)
Nodular elevated28 (49.1)35 (63.6)
Presence of clips on scar3 (5.3)8 (14.6)0.12
Residual neoplasia on histology assessment0.74
Negative38 (66.7)35 (63.6)
Positive19 (33.3)20 (36.4)
Polyps resected (mean, SD)2.4 (2.7)2.4 (2.7)0.92
Mean time baseline EPMR colonoscopy (min)55.951.90.38
Table 3 Diagnostic performance of white light endoscopy and narrow band imaging for each group
WLE-NBI group
NBI-WLE group
WLE (95%CI)NBI (95%CI)NBI (95%CI)WLE (95%CI)
Sensitivity78.9% (56.7-91.5)89.5% (68.6-97.1)85.0% (64.0-94.8)80.0% (58.4-91.9)
Specificity84.2% (69.6-92.6)84.2% (69.6-92.6)77.1% (61.0-87.9)82.9% (67.3-91.9)
False positive15.8% (7.4-30.4)15.80% (7.4-30.4)22.9% (12.1-39.0)17.1% (8.1-32.7)
False negative21.1% (8.5-43.3)10.50% (2.9-31.4)15.00% (5.2-36.0)20.0% (8.1-41.6)
PPV71.4% (50.0-86.2)73.9% (53.5-87.5)68.0% (48.4-82.8)72.7% (51.8-86.8)
NPV88.9% (74.7-95.6)94.1% (80.9-98.4)90.0% (74.4-96.5)87.9% (72.7-95.2)
LR +5 (2.3-10.8)5.7 (2.7-12.0)3.7 (2.0-7.0)4.7 (2.2-10.0)
LR -0.3 (0.1-0.6)0.1 (0.03-0.5)0.2 (0.1-0.6)0.2 (0.1-0.6)
Global accuracy82.5% (70.6-90.2)86.0% (74.7-92.7)80.0% (67.6-88.4)81.8% (69.7-89.8)
AUC81.6% (70.5-92.7)86.8% (77.6-96.0)P = 0.1581.1% (70.4-91.8)81.4% (70.4-92.4)P = 0.9