The Workgroup Serrated Polyps and Polyposis (WASP) classification for optical diagnosis of colorectal diminutive polyps with iScan and the impact of the revised World Health Organization (WHO) criteria.

Autor: Soons E; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands., Bisseling TM; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands., van der Post RS; Department of Pathology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands., Nagtegaal ID; Department of Pathology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands., Hazewinkel Y; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands., van Kouwen MCA; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands., Siersema PD; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2021 Sep; Vol. 9 (7), pp. 819-828. Date of Electronic Publication: 2021 Sep 03.
DOI: 10.1002/ueg2.12129
Abstrakt: Background and Aims: The Workgroup Serrated Polyps and Polyposis (WASP) developed criteria for optical diagnosis of colorectal polyps. The aims of this study were: (1) to improve optical diagnosis of diminutive colorectal polyps, especially SSLs, after training endoscopists in applying WASP criteria on videos of polyps obtained with iScan and (2) to evaluate if the WASP criteria are still useful when polyps are pathologically revised according to the World Health Organization (WHO) 2019 criteria.
Methods: Twenty-one endoscopists participated in a training session and predicted polyp histology on 30 videos of diminutive polyps, before and after training (T 0 and T 1 ). After three months, they scored another 30 videos (T 2 ). Primary outcome was overall diagnostic accuracy (DA) at T 0 , T 1 and T 2 . Polyps were histopathologically classified according to the WHO 2010 and 2019 criteria.
Results: Overall DA (both diminutive adenomas and SSLs) significantly improved from 0.58 (95% CI 0.55-0.62) at T 0 to 0.63 (95% CI 0.60-0.66, p = 0.004) at T 1 . For SSLs, DA did not change with 0.51 (95% CI 0.46-0.56) at T 0 and 0.55 (95% CI 0.49-0.60, p = 0.119) at T 1 . After three months, overall DA was 0.58 (95% CI 0.54-0.62, p = 0.787, relative to T 0 ) while DA for SSLs was 0.48 (95% CI 0.42-0.55, p = 0.520) at T 2 . After pathological revision according to the WHO 2019 criteria, DA of all polyps significantly changed at all time points.
Conclusion: A training session in applying WASP criteria on endoscopic videos made with iScan did not improve endoscopists' long-term ability to optically diagnose diminutive polyps. The change of DA following polyp revision according to the revised WHO 2019 criteria suggests that the WASP classification may need revision.
(© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.)
Databáze: MEDLINE
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