RESUMO
Background: Narrow-Band imaging International Colorectal Endoscopic (NICE) could reduce histopathology study requirements in colorectal polyp evaluation. Local and regional studies are required to validate its utility. Objectives: To evaluate concordance between NICE classification and histopathology. Design: Prospective analytic study performed in the Hospital Universitario San Ignacio, Bogotá (Colombia) between 2021 and 2022. Methods: Concordance between NICE I, II and III classification and histopathology [Hyperplastic Polyp (HP), adenoma and deep submucosal invasive cancer (DSIC)] was evaluated using weighted kappa. Diagnostic performance was evaluated for NICE I-II versus NICE III for DSIC versus adenoma/HP. A subgroup analysis was performed for polyps ⩾10 mm and those located in the rectum, sigmoid, and left colon. Results: A total of 238 polyps from 135 patients were evaluated. Median age 67 years (IQR 58.5-74.5), 54.4% males. 23 (17.1%) had ⩾3 polyps. Of polyps, 52.1% were located on rectum, sigmoid and left colon. A total of 182 (76.5%) were <10 mm. NICE and histopathology evidenced a fair-moderate concordance (quadratic weighted kappa 0.36, linear weighted kappa 0.43). NICE classification (NICE I-II versus III) compared to histopathology (DSIC versus adenoma/HP) evidenced a sensitivity of 90.9% and specificity of 99.1%. For DSIC diagnosis specificity was ⩾95% on polyps ⩾10 mm and those left sided located. Conclusion: NICE and histopathology concordance is suboptimal. However, NICE III for DSIC diagnosis evidence good specificity. Therefore, NICE III polyps require a prompt histopathological evaluation and follow-up. Good operative characteristics stand in polyps ⩾10 mm and left sided located. NBI formal training is recommended in gastroenterology units in Latin America.
Concordance between colonoscopy polyp evaluation with NBI optical technology and histopathology evaluation Most colorectal cancer are developed from polyps. A proper polyp evaluation is required to orientate which polyp could be a potential neoplasia. However, a definitive diagnosis is made according to histopathology evaluation. On the other hand, Narrow-Band imaging International Colorectal Endoscopic (NICE) classification based on colonoscopy could predict neoplastic polyps and drive therapeutic decisions. Our tertiary center study in Colombia evidence that NICE classification predicts adequately neoplastic polyps but is suboptimal to categorize low risk polyps. Therefore, histopathology polyp evaluation should be still recommended and NBI formal training is recommended in gastroenterology units in Latin -America.
