Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis

Table 1 Detailed tentative criteria for interpretation of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications compared with histologic diagnosis

Interpretation	JNET	Pit pattern	Histological diagnosis	Therapeutic strategy
Non-neoplastic		I	Normal mucosa
	Type 1	II	Hyperplastic/SSL	Follow-up observation
Neoplastic	Type 2A	IIIL + IV	Adenoma/LGD	Endoscopic resection (polypectomy/EMR)
	Type 2B	IIIS + VI-L	HGD/M-SM-s cancer	Endoscopic resection (ESD)
	Type 3	VN + VI-H	SM-d cancer	Surgery

JNET: Japan Narrow-band-imaging Expert Team; EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection.

Table 2 General characteristics of the included studies

Ref.	Year	Country	Study design	Patients (n)	Lesions (n)	Type of endoscopy	Typeof classification	Category
Shibagaki et al[13]	2020	Japan	Retrospective	432	718	A-NBI-ME	JNET/Pit pattern	1/2A/2B/3; I, II, III/IV, VI-L, VI-H, VN
Kobayashi et al[5]	2019	Japan	Retrospective	750	1402	NBI-ME	JNET/Pit pattern	1/2A/2B/3; I, II, IIIL, IIIS, IV, IVH, VI-L, VI-H, VN
Sumimoto et al[14]	2017	Japan	Retrospective	1901	2933	NBI-ME	JNET	1/2A/2B/3
Murano et al[15]	2019	Japan	Retrospective	680	1472	NBI-ME	JNET	1/2A/2B/3
Komeda et al[16]	2017	Japan	Retrospective	199	199	NBI-ME	JNET	1/2A/2B/3
Suzuki et al[17]	2019	Japan	Retrospective	145	185	BLI-ME	JNET	1/2A/2B/3
Hirata et al[18]	2019	Japan	Retrospective	6138	6138	NBI-ME	JNET	1/2A/2B/3
Sakamoto et al[19]	2019	Japan	Retrospective	246	246	NBI-ME	JNET	1/2A/2B/3
Gonai et al[20]	2020	Japan	Retrospective	153	169	NBI-ME	JNET	2A/2B/3
Kawasaki et al[21]	2019	Japan	Retrospective	17	17	NBI-ME	JNET/Pit pattern	1/2A/2B/3; III, IV, VI-L, VI-H, VN
Nakano et al[23]	2017	Japan	Prospective	506	799	BLI-ME	Pit pattern	II, IIIL, IIIS/IV, VI-L, VI-H/VN
Miroslaw et al[24]	2015	Poland	Prospective	270	386	WL, NBI-ME	Pit pattern	I/II/IIIL/IIIS/IV/V
Su et al[25]	2004	China	Prospective	230	270	Magnifying chromoendoscopy	Pit pattern	I/II/IIIS/IIIL/IV/V
Kiesslich et al[26]	2001	Germany	Prospective	100	283	Magnifying chromoendoscopy	Pit pattern	I/II/IIIS/IIIL/IV/V
Kawaguti et al[27]	2019	Brazil	Prospective	121	123	Magnifying chromoendoscopy	Pit pattern	II/IIIS/IIIL/IV/V
East et al[28]	2008	United Kingdom	Prospective	62	116	NBI-ME	Pit pattern	I/II/IIIS/IIIL/IV/V
Liu et al[29]	2003	China	Prospective	948	954	Magnifying chromoendoscopy	Pit pattern	I/II/IIIL/IIIS/IV/V
Kato et al[30]	2006	Japan	Prospective	180	210	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Van den Broek et al[31]	2011	Netherlands	Prospective	48	153	NBI	Pit pattern	Neoplastic/non-neoplastic
Togashi et al[32]	2009	Japan	Prospective	50	107	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Kiesslich et al[33]	2003	Germany	Prospective	84	118	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Hurlstone et al[34]	2005	United Kingdom	Prospective	350	288	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Tischendorf et al[35]	2007	Germany	Prospective	52	100	NBI-ME	Pit pattern	Neoplastic/non-neoplastic
Tischendorf et al[35]	2007	Germany	Prospective	47	100	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Su et al[36]	2006	China	Prospective	79	110	Chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Dos Santos et al[37]	2012	Brazil	Prospective	69	120	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Dos Santos et al[38]	2010	Brazil	Prospective	72	137	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Rogart et al[39]	2008	United States	Prospective	131	265	NBI	Pit pattern	Neoplastic/non-neoplastic
Apel et al[40]	2006	Germany	Prospective	158	273	Chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Van den Broek et al[41]	2008	Netherlands	Prospective	50	98	NBI-ME	Pit pattern	Neoplastic/non-neoplastic
Chiu et al[42]	2007	China	Prospective	133	180	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic
Liu et al[22]	2008	China	Retrospective	223	451	Magnifying chromoendoscopy	Pit pattern	Neoplastic/non-neoplastic

JNET: Japan Narrow-band-imaging Expert Team; NBI: Narrow band imaging; NBI-ME: NBI magnifying endoscopy; WL: White light; BLI: Blue laser imaging; A-NBIME: NBIME with acetic acid enhancement.

Table 3 Summary of the results of each category for the Japan Narrow-band-imaging Expert Team classification and the Pit pattern classification corresponding to histological diagnosis in the included studies

JNET	Sensitivity	Specificity	DOR	AUC	Pit pattern	Sensitivity	Specificity	DOR	AUC
1	0.73 [0.55, 0.85]	0.99 [0.97, 1.00]	245 [64, 936]	0.97 [0.95, 0.98]	II	0.76 [0.62, 0.86]	0.96 [0.88, 0.98]	68 [15, 309]	0.92 [0.90, 0.94]
2A	0.88 [0.78, 0.94]	0.72 [0.64, 0.79]	19 [11, 33]	0.84 [0.81, 0.87]	IIIL + IV	0.80 [0.67, 0.89]	0.80 [0.74, 0.86]	17 [8, 34]	0.87 [0.83, 0.89]
2B	0.56 [0.47, 0.64]	0.91 [0.79, 0.96]	13 [7, 24]	0.72 [0.68, 0.76]	IIIS + VI-L	0.45 [0.23, 0.69]	0.88 [0.75, 0.94]	6 [1, 26]	0.79 [0.75, 0.82]
3	0.51 [0.42, 0.61]	1.00 [1.00, 1.00]	801 [267, 2398]	0.90 [0.87, 0.93]	VN + VI-H	0.73 [0.55, 0.85]	0.99 [0.98, 1.00]	449 [93, 2182]	0.98 [0.97, 0.99]
Non-neoplastic	0.73 [0.55, 0.85]	0.99 [0.97, 1.00]	245 [64, 936]	0.97 [0.95, 0.98]	Non-neoplastic	0.86 [0.81, 0.90]	0.94 [0.90, 0.96]	88 [48, 156]	0.95 [0.93, 0.97]

JNET: Japan Narrow-band-imaging Expert Team; NBI: Narrow-band-imaging; DOR: Diagnostic odds ratio; AUC: Area under the curve.

Table 4 Summary of the results of Spearman’s correlation coefficient of each category for the Japan Narrow-band-imaging Expert Team classification and the Pit pattern classification corresponding to histological diagnosis in the included studies

JNET (type)	Coef	P value	Pit pattern (type)	Coef	P value
			Non-neoplastic	-0.12	0.02
Type 1 (Non-neoplastic)	0.14	0.02	II	0.45	0.20
Type 2A	-0.70	0.49	IIIL + IV	-0.24	0.06
Type 2B	-1.00	1.00	IIIS + VI-L	0.41	0.17
Type 3	-0.17	0.03	VN + VI-H	1.00	1.00

JNET: Japan Narrow-band-imaging Expert Team.

Table 5 Summary of the results of meta-regression analysis of each category for the Japan Narrow-band-imaging Expert Team classification and the Pit pattern classification corresponding to histological diagnosis in the included studies

Classification	Type	P value
		Prodesign	Sampsize	Qscore	Endoscopy	Category	Country	Pubyear
JNET	Type 1	0.26		0.63	0.06
	Type 2A		0.88	0.58	0.76	0.00
	Type 2B
	Type 3		0.57	0.12	0.19
Pit pattern	II	0.52		0.00	0.04		0.35	0.00
	IIIL + IV	0.63	0.77	0.41	0.33	0.77	0.00	0.09
	IIIS + VI-L	0.35	0.35	0.66	0.35	0.35	0.21	0.02
	VN + VI-H
	Non-neoplastic	0.49	0.60	0.04	0.52	0.05	0.03	0.00

JNET: Japan Narrow-band-imaging Expert Team.

Table 6 Summary of the results of Deek’s test for publication bias of each category for the Japan Narrow-band-imaging Expert Team classification and the Pit pattern classification corresponding to histological diagnosis in the included studies

JNET (type)	n of study	Pubbias (P value)	Pit pattern (type)	No. of study	Pubbias (P value)
Type 1	8	0.26	II	5	0.54
Type 2A	10	0.62	IIIL + IV	10	0.41
Type 2B	9	0.52	IIIS + VI-L	6	0.09
Type 3	9	0.50	VN + VI-H	8	0.91
Non-neoplastic	8	0.26	Non-neoplastic	23	0.13

JNET: Japan Narrow-band-imaging Expert Team.