Endoscopic diagnosis for colorectal sessile serrated lesions

Figure 1 Endoscopic findings regarding sessile serrated lesions. A: ‘‘Mucus cap’’ was defined as coverage with abundant mucus; and B: Indistinct borders were defined as vague demarcations of the lesion border.

Figure 2  Flowchart of polyp enrollment.

Figure 3 Receiver-operating characteristic curve for predicting sessile serrated lesions. A: Receiver-operating characteristic (ROC) curve for predicting sessile serrated lesion (SSL) based on the endoscopic SSL diagnosis score: The area under the curve (AUC) was 0.806. The optimal cutoff value was 3, for which the endoscopic SSL diagnosis score predicted pathological SSLs with 75% sensitivity and 80% specificity; B: ROC curve for predicting SSL based on polyp size: AUC was 0.801. Size ≥ 6 mm predicted pathological SSLs with 82% sensitivity, and 63% specificity; C: ROC curve for predicting SSL based on mucus cap: AUC was 0.727. The presence of mucus cap predicted pathological SSLs with 92% sensitivity, and 54% specificity; and D: ROC curve for predicting SSL based on indistinct borders: AUC was 0.723. The presence of indistinct borders predicted pathological SSLs with 83% sensitivity, and 61% specificity.

Figure 4 Sessile serrated lesion diagnosis rates based on the endoscopic sessile serrated lesion diagnosis score. ^aP < 0.05 compared to an endoscopic Sessile serrated lesion diagnosis score of 0; ^bP < 0.001 compared to an endoscopic sessile serrated lesion diagnosis score of 0, 1, or 2. SSL: Sessile serrated lesion.