Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jul 15, 2023; 15(7): 1271-1282
Published online Jul 15, 2023. doi: 10.4251/wjgo.v15.i7.1271
Development and validation of an online calculator to predict the pathological nature of colorectal tumors
Ya-Dan Wang, Jing Wu, Bo-Yang Huang, Chun-Mei Guo, Cang-Hai Wang, Hui Su, Hong Liu, Miao-Miao Wang, Jing Wang, Li Li, Peng-Peng Ding, Ming-Ming Meng
Ya-Dan Wang, Chun-Mei Guo, Cang-Hai Wang, Hui Su, Hong Liu, Miao-Miao Wang, Jing Wang, Li Li, Peng-Peng Ding, Ming-Ming Meng, Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Jing Wu, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing 100050, China
Bo-Yang Huang, Department of Gastroenterology, Beijing Shijitan Hospital, the Ninth Clinical Medicine Peking University, Beijing 100038, China
Author contributions: Wang YD and Wu J designed the research study; Huang BY, Guo CM, Wang CH, Su H, Liu H, Wang MM, Wang J, Li L, Ding PP and Meng MM performed the primary literature and data extraction; Wang YD analyzed the data and wrote the manuscript; Wu J was responsible for revising the manuscript for important intellectual content; All authors read and approved the final version.
Supported by Capital’s Funds for Health Improvement and Research, No. 2020-4-2085; and Beijing Science and Technology Plan Project, No. Z211100002921028.
Institutional review board statement: The study was reviewed and approved by the Beijing Shijitan Hospital, Capital Medical University Institutional Review Board, No. Sjtkyll-lx-2020 (19); and No. Sjtkyll-lx-2022 (033).
Informed consent statement: Prior to enrollment, all study participants or their legal guardians provided informed written consent for personal and medical data collection.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at wujing36youyi@ccmu.edu.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Wu, DO, MD, PhD, Dean, Doctor, Professor, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, No. 59 Yong’an Road, Xicheng District, Beijing 100050, China. wujing36youyi@ccmu.edu.cn
Received: April 1, 2023
Peer-review started: April 1, 2023
First decision: April 19, 2023
Revised: April 27, 2023
Accepted: May 22, 2023
Article in press: May 22, 2023
Published online: July 15, 2023
Abstract
BACKGROUND

No single endoscopic feature can reliably predict the pathological nature of colorectal tumors (CRTs).

AIM

To establish and validate a simple online calculator to predict the pathological nature of CRTs based on white-light endoscopy.

METHODS

This was a single-center study. During the identification stage, 530 consecutive patients with CRTs were enrolled from January 2015 to December 2021 as the derivation group. Logistic regression analysis was performed. A novel online calculator to predict the pathological nature of CRTs based on white-light images was established and verified internally. During the validation stage, two series of 110 images obtained using white-light endoscopy were distributed to 10 endoscopists [five highly experienced endoscopists and five less experienced endoscopists (LEEs)] for external validation before and after systematic training.

RESULTS

A total of 750 patients were included, with an average age of 63.6 ± 10.4 years. Early colorectal cancer (ECRC) was detected in 351 (46.8%) patients. Tumor size, left semicolon site, rectal site, acanthosis, depression and an uneven surface were independent risk factors for ECRC. The C-index of the ECRC calculator prediction model was 0.906 (P = 0.225, Hosmer–Lemeshow test). For the LEEs, significant improvement was made in the sensitivity, specificity and accuracy (57.6% vs 75.5%; 72.3% vs 82.4%; 64.2% vs 80.2%; P < 0.05), respectively, after training with the ECRC online calculator prediction model.

CONCLUSION

A novel online calculator including tumor size, location, acanthosis, depression, and uneven surface can accurately predict the pathological nature of ECRC.

Keywords: Pathological nature, Colorectal tumors, White-light endoscopy, Online calculator, Early colorectal cancer

Core Tip: White light endoscopy remains the most basic and indispensable tool in diagnosing colorectal tumors (CRTs). No single endoscopic feature can reliably predict the pathological nature of CRTs. Here, we investigated the endoscopic findings of CRTs, including lobulation, erosion, expansion, depression, acanthosis, lifting sign, stiffness, nodules larger than 10 mm, and so on. A logistic regression analysis was performed, and a novel online calculator for predicting the pathological nature of CRTs based on white-light imaging was established and verified.