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首页> 外文期刊>Endoscopy International Open >Optical diagnosis of diminutive polyps in the Dutch Bowel Cancer Screening Program: Are we ready to start?
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Optical diagnosis of diminutive polyps in the Dutch Bowel Cancer Screening Program: Are we ready to start?

机译：荷兰肠癌筛查计划中息肉的光学诊断：我们准备开始吗？

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Background and study aims?Implementation of optical diagnosis of diminutive polyps may potentially increase the efficacy and cost-effectiveness of colonoscopies. To adopt such strategy in clinical practice, the Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) thresholds provide the basis to be met: ≥?90?% negative predictive value (NPV) for diagnosis of adenomatous histology and ≥?90?% agreement on surveillance intervals. We evaluated this within the Dutch Bowel Cancer Screening Program (BCSP). Patients and methods?Endoscopic and histological data were collected from participants of the national bowel cancer screening program with an unfavorable fecal immunochemical test referred for colonoscopy between February 2014 and August 2015 at four endoscopy centers. The “resect and discard” scenario was studied, resecting diminutive polyps without histological evaluation. Agreement between optical diagnosis and histological diagnosis was measured for surveillance intervals according to Dutch, European and American post-polypectomy surveillance guideline. Results?Fifteen certified endoscopists participated in this study and included 3028 diminutive polyps. In 2,330 patients both optical and histological diagnosis were available. Optical diagnosis of diminutive polyps showed NPV of 84?% (95?% CI 80–87) for adenomatous histology in the rectosigmoid. Applying the ‘resect and discard’ strategy resulted in 90.6?%, 91.2?%, 90.9?% agreement on surveillance intervals for the Dutch, European and American guideline respectively. Conclusion?Our data representing current clinical practice in the Dutch BCSP practice on optical diagnosis of diminutive polyps showed that accuracy of predicting histology remains challenging, and risk of incorrect optical diagnosis is still significant. Therefore, it is too early to safely implement these strategies. sup*/sup These authors contributed equally.
机译：背景和研究旨在？实施光学诊断小息肉的实施可能会增加结肠镜检查的功效和成本效果。在临床实践中采用此类策略，保存和融合有价值的内窥镜创新（PIVI）阈值提供了所满足的基础：≥≤90？％的阴性预测值（NPV），用于诊断腺瘤组织学和≥90？％协议在监控间隔。我们在荷兰肠癌筛查计划（BCSP）中评估了这一点。患者和方法？从国家肠癌筛查计划的参与者收集内镜和组织学数据，其在2014年2月和2015年8月在四个内窥镜检查中心转入结肠镜检查的不利粪便免疫化学测试。研究了“切断和丢弃”情景，在没有组织学评估的情况下重接息肉。根据荷兰，欧美后霉菌监测指南测量光学诊断与组织学诊断之间的协议。结果？十五次认证的内窥镜师参加了这项研究，包括3028个小息肉。在2,330名患者中，可获得光学和组织学诊断。微息息肉的光学诊断显示为肠苷中的腺瘤组织学的84℃（95〜％CI 80-87）的NPV。应用“切割和丢弃”策略，导致90.6？％，91.2？％，90.9？分别对荷兰，欧洲和美国指南的监督间隔的达成协议。结论？我们代表荷兰语BCSP实践中的当前临床实践的数据对息肉的光学诊断表明，预测组织学的准确性仍然有挑战性，并且光学诊断不正确的风险仍然很大。因此，安全地实施这些策略太早了。 * 这些作者平均贡献。

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