Validation of Probe-based Confocal Laser Endomicroscopy (pCLE) Criteria for Diagnosing Colon Polyp Histology.
J Clin Gastroenterol
; 52(9): 812-816, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-28885303
ABSTRACT
BACKGROUND:
Validated probe-based confocal endomicroscopy (pCLE) criteria for distinguishing hyperplastic polyps (HPs) and tubular adenomas (TA) have not yet been developed.AIM:
To develop pCLE criteria for distinguishing HP from TA and evaluate its performance characteristics among experts.METHODS:
pCLE criteria for colon polyp histology were developed and tested in 2 phases prospectively. Phase I 8 preliminary criteria were developed and tested internally. Criteria achieving an accuracy of >75% (epithelial surface regular vs. irregular; goblet cells increased vs. decreased; gland axis horizontal vs. vertical; gland shape slit/stellate vs. villiform; image scale gray vs. dark) were evaluated in Phase II of study wherein external assessors evaluated these criteria in a separate set of pCLE videos. Accuracy and interobserver agreement (95% confidence intervals) were determined for colon histology prediction.RESULTS:
Phase I (criteria development/internal testing) 8 criteria were assessed by 4 pCLE experts using 28 videos (14 HP/14 TA). Five of 8 pCLE criteria met selection for phase II (accuracy >75%). Phase II (external validation) 36 pCLE colon polyp videos (HP 16/TA 20) were evaluated by 8 external assessors. Overall accuracy in diagnosis of colon polyp histology was 84.9% (95% confidence interval, 81.7-87.7). Of predictions made with high confidence (75%), histology was predicted with an accuracy of 91%, sensitivity 83%, specificity 100%, negative predictive value 87% and positive predictive value 98%. Interobserver agreement was substantial (κ=0.73).CONCLUSIONS:
We demonstrate the development and validation of pCLE criteria for prediction of colon polyp histology. Using these criteria, overall accuracy in differentiating TA from HP was high with substantial interobserver agreement.
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Base de dados:
MEDLINE
Assunto principal:
Adenoma
/
Pólipos do Colo
/
Pólipos Adenomatosos
/
Microscopia Confocal
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article