ABSTRACT
Objective To evaluate the efficacy of NICE classification in non-magnifying narrow band imaging for real-time histologic prediction and therapeutic guidance of colorectal lesions. Methods According to NICE classification, histologic prediction and therapeutic guidance were given for raised or flat raised colorectal mucosal lesions. According to pathology following biopsy, endoscopy or surgery, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification were valued. The observation consistency test was also carried out. Results 241 patients with 307 lesions were studied. The non-neoplastic lesions were 12.07%, adenomatous lesions were 82.07%, carcinomas were 5.86%. The lesions ranged from 0.1 cm to 6.0 cm in diameter. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification in differentiating non-neoplastic and neoplastic lesions were 97.04%, 89.19%, 96.09%, 98.50%, 80.49%. The Kappa of non-neoplastic and neoplastic lesions was 0.795. The Kappa of submucosal deep infiltrating lesions and lesions above superficial submucosa was 0.875. The total Kappa was 0.814. Conclusion NICE classification can accurately predict the histology of colorectal lesions and guide treatments. It is help to the moderate treatment mode in which merely neoplastic lesions are included in endoscopic resections or surgical procedures.
ABSTRACT
Objective To investigate the value of NICE classification on real-time diagnosis for neoplastic and non-neoplastic colorectal polyps. Methods The histological type of 107 polypoid lesions from 50 patients detected by colonoscopy was predicted by 4 endoscopic physicians using NICE classification, including 1 chief physician, 2 associate chief physician, and 1 attending physician. Taking pathological result as gold standard, the real-time diagnostic accuracy of NICE classification for neoplastic colorectal polyps was evaluated, and the differences of diagnostic accuracy between the 4 endoscopic physicians were compared. Results Among the 107 polypoid lesions, 49 were neoplastic polyps and 58 were non-neoplastic polyps. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification on determination of the histological type of polyps were 81. 6% (40/49), 70. 0% (40/58), 74. 8% ( 80/107) , 70. 0%( 40/58) , and 81. 6%( 40/49) , respectively. There was no statistical difference on the prediction ability between the 4 physicians using NICE classification. Conclusion NICE classification is a feasible method for real-time prediction of histology type of colorectal polyps, and it is undemanding to the qualifications of physicians.
ABSTRACT
Objective To investigate the value of NICE classification on real-time diagnosis for neoplastic and non-neoplastic colorectal polyps. Methods The histological type of 107 polypoid lesions from 50 patients detected by colonoscopy was predicted by 4 endoscopic physicians using NICE classification, including 1 chief physician, 2 associate chief physician, and 1 attending physician. Taking pathological result as gold standard, the real-time diagnostic accuracy of NICE classification for neoplastic colorectal polyps was evaluated, and the differences of diagnostic accuracy between the 4 endoscopic physicians were compared. Results Among the 107 polypoid lesions, 49 were neoplastic polyps and 58 were non-neoplastic polyps. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification on determination of the histological type of polyps were 81. 6% (40/49), 70. 0% (40/58), 74. 8% ( 80/107) , 70. 0%( 40/58) , and 81. 6%( 40/49) , respectively. There was no statistical difference on the prediction ability between the 4 physicians using NICE classification. Conclusion NICE classification is a feasible method for real-time prediction of histology type of colorectal polyps, and it is undemanding to the qualifications of physicians.
ABSTRACT
Objective To evaluate the diagnostic efficacy of non-magnified NBI in distinguishing neoplastic from non-neoplastic colorectal polyps,using a simple classification system(NBI international colo-rectal endoscopic[NICE]classification).Methods A total of 181 lesions detected by white light colonosco-py were enrolled in this prospective study.Each lesion was assessed by NBI,and the histology was predicted according to characteristics of lesion color,microvascular architecture,and surface pattern.The results were compared with actual histologic findings.Results The diagnostic sensitivity,specificity,PPV,NPV,and accuracy of NBI were 95. 8%(114/119),91. 9%(57/62),95. 8%(114/119),91. 9%(57/62),and 94. 5%(171/181),respectively.Diagnostic accuracy was 90. 0%(72/80)in the 1 to 5 mm group,95. 9%(47/49)in the 6 to 9 mm group,98. 1%(51/52)in the more than 10 mm group,with no statistically sig-nificant differences(P=0. 175).The sensitivity,specificity,PPV,NPV,and accuracy of NBI for diminu-tive rectosigmoid neoplasms were 87. 5%(14/16),95. 2%(20/21),93. 3%(14/15),90. 9%(20/22), and 91. 9%(34/37).Conclusion NICE classification with non-magnified NBI is effective in distinguishing neoplastic from non-neoplastic colorectal lesions.