Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Gastroenterology, Harasanshin General Hospital, Fukuoka, Japan.
Dig Endosc. 2019 Sep;31(5):544-551. doi: 10.1111/den.13393. Epub 2019 May 7.
The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants.
Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared.
Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90% accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training.
The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis.
日本窄带成像（NBI）专家小组（JNET）分类是一种最近提出的基于 NBI 放大内镜的结直肠肿瘤分类系统。尽管 JNET 专家已经报告了该系统的有用性，但它的客观有效性仍不清楚。我们通过包括结肠镜专家和非专家作为测试参与者，测试了该系统在诊断结直肠息肉中的有效性和实用性。
向 22 名医生（11 名专家和 11 名非胃肠[GI]受训者）展示了 40 个不同 JNET 类型的息肉的 NBI 图像，这些医生没有检查过患者。医生仅根据放大图像中的表面和血管模式以及 JNET 分类系统来诊断息肉。确定他们的诊断与息肉的病理结果的一致性率，并比较专家和非 GI 受训者的结果。
对于结肠镜专家和非 GI 受训者来说，JNET 分类系统特别有助于将息肉分类为良性或恶性。尽管结肠镜专家对将息肉分类为每种 JNET 类型的准确率有所不同，但熟悉 JNET 分类系统的医生能够以约 90%的准确率诊断息肉。常见的错误归因于对 JNET 分类图表中的措辞的误解以及缺乏适当的培训。
JNET 分类系统是诊断结直肠息肉的一种实用方法。即使对于有经验的结肠镜医生，也需要进行培训才能正确采用该系统。必须在结肠镜医生之间共享常见的陷阱，以提高诊断的准确性。
