Unified Magnifying Endoscopic Classification (UMEC) of Gastrointestinal Lesions: A North American Validation Study.

Autor:	Fujiyoshi MRA; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8.; Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, Japan 135-8577., Fujiyoshi Y; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8.; Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, Japan 135-8577., Gimpaya N; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Bechara R; Division of Gastroenterology, Queen's University, Sydenham 4, 166 Brock Street, Kingston, Ontario, Canada K7L 5G2., Jeyalingam T; Division of Gastroenterology, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4., Calo NC; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Forbes N; Division of Gastroenterology, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6., Pawlak KM; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Khalaf K; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Khan R; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Atalla M; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Toshimori A; Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, Japan 135-8577., Shimamura Y; Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, Japan 135-8577., Tanabe M; Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, Japan 135-8577., Teshima C; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Mosko JD; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., May G; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8., Inoue H; Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, Japan 135-8577., Grover SC; Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada, M5A 2H8.
Jazyk:	angličtina
Zdroj:	Journal of the Canadian Association of Gastroenterology [J Can Assoc Gastroenterol] 2023 Dec 09; Vol. 7 (3), pp. 246-254. Date of Electronic Publication: 2023 Dec 09 (Print Publication: 2024).
DOI:	10.1093/jcag/gwad055
Abstrakt:	Background and Study Aim: Magnifying endoscopy enables the diagnosis of advanced neoplasia throughout the gastrointestinal tract. The unified magnifying endoscopic classification (UMEC) framework unifies optical diagnosis criteria in the esophagus, stomach, and colon, dividing lesions into three categories: non-neoplastic, intramucosal neoplasia, and deep submucosal invasive cancer. This study aims to ascertain the performance of North American endoscopists when using the UMEC. Methods: In this retrospective cohort study, five North American endoscopists without prior training in magnifying endoscopy independently diagnosed images of gastrointestinal tract lesions using UMEC. All endoscopists were blinded to endoscopic findings and histopathological diagnosis. Using histopathology as the gold standard, the endoscopists' diagnostic performances using UMEC were evaluated. Results: A total of 299 lesions (77 esophagus, 92 stomach, and 130 colon) were assessed. For esophageal squamous cell carcinoma, the sensitivity, specificity, and accuracy ranged from 65.2% (95%CI: 50.9-77.9) to 87.0% (95%CI: 75.3-94.6), 77.4% (95%CI: 60.9-89.6) to 96.8% (95%CI: 86.8-99.8), and 75.3% to 87.0%, respectively. For gastric adenocarcinoma, the sensitivity, specificity, and accuracy ranged from 94.9% (95%CI: 85.0-99.1) to 100%, 52.9% (95%CI: 39.4-66.2) to 92.2% (95%CI: 82.7-97.5), and 73.3% to 93.3%. For colorectal adenocarcinoma, the sensitivity, specificity, and accuracy ranged from 76.2% (95%CI: 62.0-87.3) to 83.3% (95%CI: 70.3-92.5), 89.7% (95%CI: 82.1-94.9) to 97.7% (95%CI: 93.1-99.6), and 86.8% to 90.7%. Intraclass correlation coefficients indicated good to excellent reliability. Conclusion: UMEC is a simple classification that may be used to introduce endoscopists to magnifying narrow-band imaging and optical diagnosis, yielding satisfactory diagnostic accuracy. Competing Interests: H. I. has received personal fees from Olympus Corporation and Top Corporation. He has also received educational grants from Olympus Corp., and Takeda Pharmaceutical Co. S. C. G. has received research grants and personal fees from AbbVie and Ferring Pharmaceuticals, personal fees from Takeda, education grants from Janssen, and has equity in Volo Healthcare. All other authors have no relevant disclosures. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.)
Databáze:	MEDLINE
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