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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Diagnostic performance of endoscopic classifications for neoplastic lesions in patients with ulcerative colitis: A retrospective case-control study
Yuichi Kida, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Eri Ishikawa, Yasuyuki Mizutani, Naomi Kakushima, Kazuhiro Furukawa, Takuya Ishikawa, Eizaburo Ohno, Hiroki Kawashima, Masanao Nakamura, Masatoshi Ishigami, Mitsuhiro Fujishiro
Yuichi Kida, Takeshi Yamamura, Eri Ishikawa, Yasuyuki Mizutani, Naomi Kakushima, Kazuhiro Furukawa, Takuya Ishikawa, Eizaburo Ohno, Masanao Nakamura, Masatoshi Ishigami, Mitsuhiro Fujishiro, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Aichi, Japan
Keiko Maeda, Tsunaki Sawada, Hiroki Kawashima, Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
Mitsuhiro Fujishiro, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Kida Y and Yamamura T contributed to the conception and design; Kida Y, Yamamura T, Kawashima H, Ishikawa E, and Kakushima N contributed to the analysis and interpretation of the data; Kida Y drafted the article; Nakamura M, Ohno E, Sawada T, Maeda K, Ishikawa T, Ishigami M, and Furukawa K contributed to the critical revision of the article for important intellectual content; Mizutani Y, Yamamura T and Nakamura M contributed to statistical analysis; Fujishiro M made the final approval of the article; all authors have read and approved the final manuscript.
Institutional review board statement: The use of patient data for this study was approved by the Ethics Committee of Nagoya University Hospital, No. 2015-0485.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
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: Takeshi Yamamura, MD, PhD, Assistant Professor, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Aichi, Japan. tyamamu@med.nagoya-u.ac.jp
Received: September 14, 2021
Peer-review started: September 14, 2021
First decision: November 16, 2021
Revised: November 29, 2021
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: March 14, 2022
ARTICLE HIGHLIGHTS
Research background
Patients with long-standing ulcerative colitis (UC) have a risk of colorectal tumors due to chronic inflammation. Endoscopic treatments for patients with UC have gradually increased and have attracted attention recently.
Research motivation
Surface and vascular patterns of tumors located in the inflamed mucosa are likely to be modified by inflammation. For that reasons, it is unclear whether the Japan Narrow-Band Imaging Expert Team (JNET) classification and pit pattern classification are applicable to the diagnosis of neoplastic lesions in patients with UC.
Research objectives
The present study aimed to clarify the diagnostic performance of JNET and pit pattern classifications for neoplastic lesions in patients with UC.
Research methods
We analyzed 41 UC patients with 44 lesions that could be assessed using both the JNET and pit pattern classifications. We devided them into the UC-associated neoplasms (UCAN) group (21 lesions) and sporadic neoplasms (SN) group (23 lesions) according to the pathological results. Six endoscopists each evaluated the endoscopic findings by using both endoscopic classifications.
Research results
In the UCAN group, the accuracy of diagnosis for JNET types 2A, 2B, and 3 by experts was 90.5%, 71.4%, and 85.7%, respectively. In the same manner, the accuracy of diagnosis for pit pattern type III/IV, type VI low irregularity, and type VI high irregularity/VN by experts was 85.7%, 57.1%, and 76.2%, respectively.
Research conclusions
The JNET and pit pattern classifications did not show high accuracy in diagnosing the pathology and invasion depth of neoplastic lesions in patients with UC. Endoscopic diagnosis of UCAN tended to be underestimated, as compared to the pathological results.
Research perspectives
Future prospective studies with a large number of UC patients are needed in clinical practice.
