Clinical value of JNET classification for non-real-time diagnosis of colorectal lesions

中华消化内镜杂志 Pub Date : 2019-05-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2019.05.006

Jing Zhou, Qing-Wei Zhang, Jian Huang, La-Mei Teng, Zhenbo Qin, Xintian Zhang, Jin-Nan Chen

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Abstract

Objective To study the diagnostic value of Japan narrow band imaging expert team (JNET) classification for differentiating pathological type of colorectal lesions. Methods A total of 418 colorectal lesions were retrospectively diagnosed by magnifying endoscopy with narrow band imaging (ME-NBI) using JNET classification by two inexperienced doctors after a short time of training in JNET classification. Then lesions were diagnosed with Sano classification by the two doctors. Diagnostic results were compared with histologic findings as a golden standard. Results The sensitivity, specificity, and accuracy of JNET classification and Sano classification for neoplastic lesion differentiation were 98.2% VS 98.5%, 77.8% VS 66.7%, and 96.9% VS 96.4%, respectively (all P>0.05). These indicators for diagnosing cancerous lesions, including high grade intraepithelial neoplasia, intramucosal carcinoma and submucosal carcinoma, were 66.7% VS 80.2% (P=0.023), 87.6% VS 79.5% (P=0.006), and 82.1% VS 79.7% (P=0.379), respectively, and those for predicting submucosal deep invasive cancers were 34.8% VS 39.1%, 100.0% VS 99.0%, and 96.4% VS 96.3%, respectively (all P>0.05). The diagnostic accuracy of JNET classification for differentiating neoplastic lesions were 95.2% in those with diameter <10 mm, 97.0% in 10~<20 mm, and 97.8% in ≥20 mm (P=0.483), this finding were 95.2%, 85.1% and 72.1% for cancer, respectively (P<0.000 1), and 100%, 96.3%, and 94.4% for submucosal deep invasive cancer, respectively (P=0.026). Shape and location of colorectal lesions showed no significant effect on the diagnostic efficacy of JNET classification. Conclusion JNET classification is valuable for doctors without experience of ME-NBI in diagnosing colorectal lesions and the efficiency is slightly superior to Sano classification. However, the accuracy of diagnosis for cancer with diameter ≥20 mm need to be improved. Key words: Intestinal polyp; Diagnostic techniques, digestive system; Diagnostic imaging; JNET classification

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JNET分类在结直肠病变非实时诊断中的临床价值

目的探讨日本窄带成像专家组(JNET)分级对结直肠病变病理类型的诊断价值。方法对418例结直肠病变进行回顾性诊断，由两名经验不足的医生在接受短时间的JNET分类培训后，采用窄带放大内镜(ME-NBI)进行JNET分类。然后由两位医生对病变进行Sano分型诊断。诊断结果比较组织学表现作为金标准。结果JNET分型和Sano分型对肿瘤病变鉴别的敏感性、特异性和准确性分别为98.2%比98.5%、77.8%比66.7%、96.9%比96.4%(均P < 0.05)。高级别上皮内瘤变、粘膜内癌、粘膜下癌的诊断指标分别为66.7% VS 80.2% (P=0.023)、87.6% VS 79.5% (P=0.006)、82.1% VS 79.7% (P=0.379)，预测粘膜下深部浸润性癌的诊断指标分别为34.8% VS 39.1%、100.0% VS 99.0%、96.4% VS 96.3% (P均为0.05)。JNET分类对直径<10 mm的诊断准确率为95.2%，10~<20 mm的诊断准确率为97.0%，≥20 mm的诊断准确率为97.8% (P=0.483)，对肿瘤的诊断准确率分别为95.2%、85.1%和72.1% (P<0.000 1)，对粘膜下深部浸润癌的诊断准确率分别为100%、96.3%和94.4% (P=0.026)。结直肠病变的形状和位置对JNET分级的诊断效果无显著影响。结论JNET分型对没有ME-NBI经验的医生诊断结直肠病变有一定的价值，其诊断效率略优于Sano分型。但对于直径≥20mm的肿瘤，其诊断准确率有待提高。关键词:肠息肉;诊断技术，消化系统;诊断成像;JNET分类

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来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.