Clinical Endoscopy

Original Article

External Validation of the Endoscopic Features of Sessile Serrated Adenomas in Expert and Trainee Colonoscopists: Hyo-Joon Yang, Jeong In Lee, Soo-Kyung Park, Yoon Suk Jung, Jin Hee Sohn, Kyu Yong Choi, Dong Il Park; Clin Endosc 2017;50(3):279-286. Published online September 13, 2016; DOI: https://doi.org/10.5946/ce.2016.107

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Background
/Aims: It is unclear whether the endoscopic features of sessile serrated adenomas (SSAs) would be useful to trainee colonoscopists to predict SSA. Therefore, the present study aimed to identify features that expert and trainee colonoscopists can use to independently and reliably predict SSA by using high-resolution white-light endoscopy.
Methods
Endoscopic images of 81 polyps (39 SSAs, 22 hyperplastic polyps, and 20 tubular adenomas) from 43 patients were retrospectively evaluated by 10 colonoscopists (four experts and six trainees). Eight endoscopic features of SSAs were assessed for each polyp.
Results
According to multivariable analysis, a mucous cap (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.72 to 19.07), indistinctive borders (OR, 4.21; 95% CI, 2.74 to 7.16), dark spots (OR, 3.64; 95% CI, 1.89 to 7.00), and cloud-like surface (OR, 2.43; 95% CI, 1.27 to 4.668) were independent predictors of SSAs. Among these, a mucous cap, indistinctive borders, and cloud-like surface showed moderate interobserver agreement (mean κ >0.40) among experts and trainees. When ≥1 of the three predictors was observed, the sensitivity and specificity for diagnosing SSAs were 79.0% and 81.4%, respectively.
Conclusions
Colonoscopy trainees and experts can use several specific endoscopic features to independently and reliably predict SSAs.

Citations

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Risk factors for sessile serrated lesions among Chinese patients undergoing colonoscopy
Ru Zhang, Yunbi Ni, Cosmos LT Guo, Rashid NS Lui, William KK Wu, Joseph JY Sung, Vincent WS Wong, Sunny H Wong
Journal of Gastroenterology and Hepatology.2023; 38(9): 1468. CrossRef
Risk factors of traditional serrated adenoma and clinicopathologic characteristics of synchronous conventional adenoma
Jeongseok Kim, Ji Young Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Ja Eun Koo, Hyo Jeong Lee, Jaewon Choe, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2019; 90(4): 636. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
Sessile Serrated Adenoma; the Hard-to-Catch Culprit of Interval Cancer
Suk Pyo Shin
Clinical Endoscopy.2017; 50(3): 215. CrossRef
Proximal Sessile Serrated Adenomas Are More Prevalent in Caucasians, and Gastroenterologists Are Better Than Nongastroenterologists at Their Detection
Malav P. Parikh, Sujit Muthukuru, Yash Jobanputra, Kushal Naha, Niyati M. Gupta, Vaibhav Wadhwa, Rocio Lopez, Prashanthi N. Thota, Madhusudhan R. Sanaka
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef

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Review

Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea: Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim; Clin Endosc 2015;48(3):216-220. Published online May 29, 2015; DOI: https://doi.org/10.5946/ce.2015.48.3.216

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Applying proper coding is important for doctors practicing gastroenterology. The coding systems established by various organizations define tumors differently. As a result of changing concepts of tumor classification, there are coding and reimbursement issues following the confirmation of malignant lesions by nationwide cancer screening in patients with intramucosal carcinoma and neuroendocrine tumors of the colorectum. In addition, there have been discrepancies between the views of endoscopists and pathologists regarding tumor coding. The Korean Society of Gastrointestinal Endoscopy held an expert meeting and established a consensus for the coding of intramucosal carcinoma and neuroendocrine tumor of the colorectum.

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4 Web of Science
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