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DOI: 10.1055/s-0042-1744738
DETECTION RATE OF SESSILE SERRATED LESIONS AND ACCURACY OF OPTICAL BIOPSY AS QUALITY INDICATORS
Aims Serrated pathway is thought to account for up to one-third of overall colorectal cancers(CRC),and a plausible cause of interval CRC.There is discordance in detection outcomes both from endoscopist and pathologist perspectives.Our study aims to report the SL detection performances in a large cohort of patients and investigate factors affecting endoscopist performances.
Methods We conducted a retrospective review of all average-risk patients screening or surveillance colonoscopies from 2019 to 2021 in our centralized pathology centre (Humanitas Research Hospital, Italy).SL detection rate (SDR),and the mean number of SL per colonoscopy (SL-PC) were assessed as primary end-point.Diagnostic accuracy of optical biopsy for SLs(defined as the rate of CR lesions detected and correctly addresses as serrated)was assessed as a secondary end-point.Endoscopists were categorizedsenior specialists (≥2000 colonoscopies),junior specialists and trainees;secondly,according to their main field of interest into luminal and not luminal endoscopists.
Results In 10368 patients (M/F=0.99,mean age:61.17±11.13),831 serrated lesions(97.9%,n=814,Sessile Serrated Lesions,SSLs;2.1%,n=17,Traditional serrated adenomas,TSAs) were detected.SL-DR widely varied among the 32 endoscopists,ranging from 1.69% to 9.56% (mean rate 5.04%,523/10368).Luminal-dedicated endoscopists presented with higher detection performances (7.08VS3.33,RR:2.13;p<0,0001).
On the other hand,overall endoscopic esperience did not affect the performances in serrated detections,with no differences among senior,junior specialist,and trainee.Overall,accuracy of optical biopsy for SL was 64%.A trend favouring luminal endoscopist emerged,similarly to SL-DR;however,no statistical significance was reported(p=0,27).
Conclusions Relevant variability in terms of serrated detection performances was confirmed among endoscopists in the same patient population and centralized pathology. SL-DR should be upgraded as a key quality indicator of detection,and this also applies to optical biopsy for their characterization.
Publication History
Article published online:
14 April 2022
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