Endoscopic features for differentiating sessile serrated lesion with dysplasia or carcinoma in serrated lesions ≥10 mm.

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease Pub Date : 2025-09-22 DOI:10.1016/j.dld.2025.09.009

Yoshihiro Kishida, Tadakazu Shimoda, Kinichi Hotta, Kenichiro Imai, Sayo Ito, Kazunori Takada, Junya Sato, Tatsunori Minamide, Yoichi Yamamoto, Masao Yoshida, Yuki Maeda, Noboru Kawata, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono

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引用次数: 0

Abstract

Background and aim: Accurate differentiation of sessile serrated lesion with dysplasia (SSLD) or with carcinoma (SSL+Ca) from hyperplastic polyp (HP) and sessile serrated lesion (SSL) is crucial for appropriate endoscopic management.

Methods: This single-center retrospective study included colorectal serrated lesions (≥10 mm) resected between 2017 and 2020 and pathologically diagnosed as HP, SSL, SSLD, or SSL+Ca based on the WHO 5th edition criteria. Characteristic factors associated with SSLD/SSL+Ca and their diagnostic performance were analyzed. Additionally, features of submucosal invasive (pT1) SSL+Ca were examined.

Results: Among 498 lesions, 23 (4.6 %) were diagnosed as SSLD/SSL+Ca, with prevalence increasing by size (10-14 mm: 1.2 %, 15-19 mm: 9.2 %, ≥20 mm: 14.3 %). Multivariate analysis identified lesion size ≥15 mm, double elevation, and neoplastic JNET type (2A/2B/3) as significant predictors. A prediction model using these factors demonstrated high diagnostic accuracy (sensitivity 91.3 %, specificity 91.8 %, accuracy 91.8 %, PPV 35.0 %, NPV 99.5 %). In pT1 SSL+Ca, JNET Type 3, Kudo's type V pit pattern, and non-lifting sign were significantly associated.

Conclusions: Among HP and SSL ≥10 mm, the prevalence of SSLD/SSL+Ca increased with lesion size. Double elevation and neoplastic JNET type were valuable for diagnosis, aiding appropriate management.

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≥10mm的无柄锯齿状病变与发育不良或癌的内镜鉴别特征。

背景与目的：准确区分伴不典型增生（SSLD）或伴癌（SSL+Ca）的无柄锯齿状病变与增生性息肉（HP）和无柄锯齿状病变（SSL）对于内镜下治疗至关重要。方法：这项单中心回顾性研究纳入了2017年至2020年间切除的结直肠锯齿状病变（≥10 mm），并根据WHO第5版标准病理诊断为HP、SSL、SSLD或SSL+Ca。分析与SSLD/SSL+Ca相关的特征因素及其诊断效果。此外，检查粘膜下浸润性（pT1） SSL+Ca的特征。结果：在498个病变中，23个（4.6%）被诊断为SSLD/SSL+Ca，患病率随大小而增加（10-14 mm: 1.2%, 15-19 mm: 9.2%,≥20 mm: 14.3%）。多因素分析发现，病变大小≥15mm、双抬高和肿瘤JNET类型（2A/2B/3）是显著的预测因素。使用这些因素建立的预测模型具有较高的诊断准确率（敏感性91.3%，特异性91.8%，准确性91.8%,PPV 35.0%, NPV 99.5%）。在pT1中，SSL+Ca、JNET 3型、Kudo的V型坑型与非隆起征显著相关。结论：在HP和SSL≥10 mm中，SSLD/SSL+Ca的患病率随着病变大小的增加而增加。双抬高和肿瘤型JNET对诊断有价值，有助于适当的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive and Liver Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

2.20%

发文量

632

审稿时长

19 days

期刊介绍： Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.