Endoscopy 2025; 57(S 02): S361-S362
DOI: 10.1055/s-0045-1805904
Abstracts | ESGE Days 2025
ePosters

Assessing dysplasia/cancer in large granular mixed laterally spreading lesions: Endoscopic classifications versus forceps biopsy

V Tkachov
1   Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
,
O Kiosov
1   Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
,
A Klymenko
1   Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
› Author Affiliations
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Aims Determine the most accurate endoscopic classification in comparison with forceps biopsy(FB) for granular mixed laterally spreading lesions(LSLs), by comparing them with histopathological findings [1] [2] [3] [4].

Methods The study included 70 patients with granular mixed LSLs with a diameter≥20mm, type 0-IIa, 0-Is or IIa+Is Paris Classification. Patients with deep invasive cancer were excluded. An expert endoscopist performed optical evaluations according to Kudo, JNET, Modified Sano and Hiroshima classifications using chromoscopy and NBI, followed by target forceps biopsy and endoscopic resection. The findings were compared to specimen histopathology using Fisher’s exact test, Wilson confidence intervals and descriptive statistics in Statistica 13.

Results Median age was 66±9.9 year; median lesion size was 40±16.7mm. 35.7% of all LSLs were removed via piecemeal EMR, 32.9% via ESD, 17.1% by EMR en block and 14.3% by hybrid ESD. Sensitivity was 67.39% (95%CI,53.8%-80.9%) for FB; 70.83%(95%CI,58%-83.7%) for JNET, 57.14%(95%CI,38.8%-75.5%) for Hiroshima and 89.58%(95%CI,80.9%-98.2%) for Modified Sano classification. Specificity was 95.83% (95%CI,87.8%-100%) for FB; 90.91%(95%CI,78.9%-100%) for JNET; 95.24%(95%CI,88.8%-100%) for Hiroshima and 54.55%(95%CI,33.7%-75.4%) for Modified Sano classification. P<0.001 in all cases. In the analysis using the Kudo classification, the p-value was 0.103, indicating that the results were not statistically significant.

Conclusions Among the classifications tested, JNET has slightly higher sensitivity and slightly lower specificity compared to forceps biopsy. Given that the Sano classification demonstrates significantly higher sensitivity but lower specificity, it may be beneficial to combine both JNET and Sano classifications to enhance diagnostic accuracy. Comparable results between optical assessment and forceps biopsy indicate that forceps biopsy is unnecessary if endoscopic removal of the lesion is planned.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

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