Copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Usefulness of analyzing endoscopic features in identifying the colorectal serrated sessile lesions with and without dysplasia
Rui-Gang Wang, Yu-Tang Ren, Xuan Jiang, Lai Wei, Xiao-Fei Zhang, Hao Liu, Bo Jiang
Rui-Gang Wang, Yu-Tang Ren, Xuan Jiang, Bo Jiang, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Lai Wei, Center for Hepatobiliary and Pancreatic Diseases, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Xiao-Fei Zhang, Center for Clinical Epidemiology and Statistics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Hao Liu, Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Author contributions: Wang RG completed the research design, data collection and analysis, and the writing and revision of the essay; Ren YT assisted in data analysis; Ren YT and Jiang X assisted in data collection; Jiang X assisted in the research design; Wei L provided guidance on the study design and method selection; Zhang XF assisted in the completion of statistical methods and participated in data analysis; Liu H assisted in completing the histopathological diagnosis of the enrolled cases; Jiang B provided guidance on the research methods and design, and assisted in completing the revision of the essay.
Institutional review board statement: The study was reviewed and approved by the Beijing Tsinghua Changgung Hospital Institutional Review Board (approval No. 21439-0-02).
Informed consent statement: All cases that signed an informed consent form and underwent endoscopic resection.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: 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: Bo Jiang, MD, Chief Doctor, Chief Physician, Doctor, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. jba00920@btch.edu.cn
Received: July 8, 2023
Peer-review started: July 8, 2023
First decision: August 30, 2023
Revised: September 11, 2023
Accepted: September 23, 2023
Article in press: September 25, 2023
Published online: October 16, 2023
ARTICLE HIGHLIGHTS
Research background
Missing diagnosis of sessile serrated lesions (SSLs), especially SSLs with dysplasia (SSL-D+s), is an important cause of interstitial colorectal cancer, and in this study, we hoped to find endoscopic features that have independent diagnostic value for SSL-D+s.
Research motivation
Previous studies on the endoscopic features of SSLs have focused on their differentiation from hyperplastic polyps and tubular adenomas, and comparisons of the endoscopic features of SSLs without dysplasia (SSL-D-s) and SSL-D+s have remained at the level of prediction of the sensitivity and specificity of individual endoscopic features. There have been several reports in the literature that SSL-D+s have a risk of faster progression to adenocarcinoma compared to SSL-D-s and conventional tubular adenomas. Therefore, it is important to look for endoscopic features that have independent predictive value for SSL-D+s and assist the endoscopist in making immediate diagnoses.
Research objectives
This study looks for endoscopic features that have independent diagnostic value for colorectal SSL-D+s. These features may help endoscopists to make immediate diagnoses during colonoscopy.
Research methods
In this study, endoscopic features potentially predictive of SSLs were first analyzed by univariate analysis, and then multivariate logistic regression analysis was performed to obtain endoscopic features with independent diagnostic value for predicting SSL-D+s and the diagnostic validity of these endoscopic features.
Research results
In univariate analysis, location, size, surface shape, color, microvascular varices, and crypt opening pattern of colorectal SSLs had value in predicting SSL-D+s. In multifactorial regression analysis, color, microvascular varices and crypt opening pattern had independent diagnostic value in predicting SSL-D+s.
Research conclusions
Reddish color, microvascular varicose, and mixed pattern of crypt openings are independent diagnostic features for colorectal SSL-D+s.
Research perspectives
This finding is expected to improve the immediate diagnostic accuracy of endoscopists in SSL-D+s in order to inform them to use appropriate endoscopic treatment modalities.
