Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

Table 1 Diagnostic performance for the histological prediction of underlying malignancy of colorectal lesions according to their morphological pattern as well as to Kudo pit pattern, narrow-band imaging international colorectal endoscopic, and Japan narrow-band imaging expert team classifications

Variables	Sensitivity	Specificity	PPV	NPV	Accuracy
Morphological pattern1
0-IIa G	5.7%	70.0%	1.7%	89.1%	64.6%
0-Is G	11.5%	83.2%	5.8%	91.2%	77.3%
0-IIa + Is G	22.9%	77.4%	8.4%	91.7%	72.8%
0-IIa NG	27.4%	79.5%	10.8%	92.4%	75.2%
0-Is NG	16.6%	95.5%	25.0%	92.7%	89.0%
0-IIa + Is NG	15.9%	94.5%	20.7%	92.6%	88.0%
Kudo pit pattern (NBI)2	73.3%-93.7%3	89.2%-100%3	93.7%-100%3	89.2%-96.4%3	92.0%-96.7%3
NICE classification4
Type 1	82.1%-84.6%	93.8%-94.9%	65.9%-92.5%	60.4-98.2%	93.9%-97.8%
Type 2	89.8%-91.4%	84.3%-86.3%	89.1%-90.7%	97.3-97.7%	56.6%-61.2%
Type 3	83.3%-91.7%	96.4%-97.0%	96.0%-96.8%	45.8-54.0%	99.4%-99.7%
JNET classification5
Type 1	73.0%-87.1%	96.0%-99.5%	73.4%-92.3%	96%-98.9%	93.0%-98.5%
Type 2A	82.5%-96.0%	70.0%-91.1%	90.3%-96.7%	62.1%-92.1%	84.5%-90.9%
Type 2B	42.0%-75.6%	84.2%-95.0%	26.0%-67.3%	92.2%-98.0%	81.3%-93.0%
Type 3	35.0%-91.7%	98.1%-100%	63.2%-100%	93.8%-99.7%	94.0%-98.0%

¹Diagnostic performance of lesion classification types according to Paris classification for covert submucosal invasive cancer (SMIC) (SMIC that is not visible on endoscopic inspection).

²Narrow-band imaging.

³These percentages refer to the ability of preoperative magnifying chromoendoscopy (Kudo pit pattern classification by narrow-band imaging assessment of mucosal surface) to predict depth of submucosal invasion for large colorectal lesions.

⁴Narrow-band imaging international colorectal endoscopic (NICE) classification, NICE type 1: hyperplastic polyps, NICE type 2: adenomas (with/without risk of a superficial SMIC), NICE type 3: strongly predictive of cancers with deep SMIC.

⁵Japan narrow-band imaging expert team classification (JNET), JNET type 1: predictive of hyperplastic/sessile serrated polyps, JNET type 2A: predictive of neoplasia with low/high-grade intramucosal neoplasia, JNET type 2B: predictive of high-grade intramucosal neoplasia/shallow submucosal invasive cancer, JNET type 3: predictive of cancer with deep SMIC. PPV: Positive predictive value; NPV: Negative predictive value; NBI: Narrow-band imaging; JNET: Japan Narrow-band imaging expert team classification; NICE: Narrow-band imaging international colorectal endoscopic; NG: Non-granular; G: Granular.