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. 2021 Jan;9(1):E14-E21.
doi: 10.1055/a-1293-7086. Epub 2021 Jan 1.

Evaluation of the optical criteria for sessile serrated lesions of the colon: A prospective study on a colorectal cancer screening population

Marco Bustamante-Balén  1   2 , Carla Satorres  1   2 , David Ramos-Soler  2   3 , Maria García-Campos  1 , Noelia Alonso  1   2 , Marta Ponce  1   2 , Lidia Argüello-Viudez  1   2 , Francisco Giner  3 , Jaime Ferrer-Lozano  3 , Vicente Pons-Beltrán  1   2
Affiliations

Evaluation of the optical criteria for sessile serrated lesions of the colon: A prospective study on a colorectal cancer screening population

Marco Bustamante-Balén et al. Endosc Int Open. 2021 Jan.

Abstract

Background and study aims We aimed to describe the presence and combination of Hazewinkel's optical diagnosis (OD) criteria for sessile serrated lesions (SSL), determining which lesion characteristics increase the probability of a correct OD, with a focus on diminutive lesions. Patients and methods This was a prospective study describing the presence of Hazewinkel's OD criteria for SSL in lesions found in consecutive CRC screening colonoscopies. The presence of each OD criterion and their diagnostic combinations in SSL, related to the lesion's NBI International Colorectal Endoscopic (NICE) classification category, size, and location, were described. The presence of two or more optical criteria was considered diagnostic of SSL. The OD was compared to pathology as the gold standard. Results Seventy-nine SSLs (5.6 %) were diagnosed. Cloud-like appearance was the most prevalent OD criterion (35, 44.3 %). OD criteria were more frequently identified in NICE type 1, ≥ 10 mm, and proximal lesions. Only 26 SLLs fulfilled the OD criteria (sensitivity 32.9 %, 95 % CI 29.1 %-36.7 %). The sensitivity for diminutive SSL was 14.7 %, (95 % CI 11.9 %-17.6 %). Eighty-five lesions were optically diagnosed as SSL. However, only in 26 SSL was this the definitive diagnosis (positive predictive value 30.6 %, 95 % CI 26.9 %-34.3 %). Size > 5 mm and proximal location increased the probability of a correct diagnosis. The overall accuracy of the optical criteria was 92.0 % (95 % CI, 89.8 %-94.2 %). Conclusions The Hazewinkel's optical criteria are not reliable for a positive diagnosis of SSL, particularly for diminutive lesions.

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Conflict of interest statement

Competing interests The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Examples of optical criteria for SSL diagnosis: a Cloud-like appearance and irregular shape. b Cloud-like appearance and black dots.
Fig. 2
Fig. 2
Frequency of each optical criterion for SSL depending on lesion characteristics. a NICE classification. b Size. c Location.
See this image and copyright information in PMC

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