Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Gastroenterol Hepatol. 2020 Aug;35(8):1365-1371. doi: 10.1111/jgh.14977. Epub 2020 Jan 21.
Serrated polyp detection rate (SDR) is a potential quality indicator for preventing colorectal cancer associated with the serrated pathway. Using clinically significant SDR (CSSDR) has been suggested based on clinically significant serrated polyp's ability to be colorectal cancer precursors. Correlations between CSSDR and simpler SDRs, other than proximal SDR, have not yet been studied. We aimed to investigate which simpler SDR indicator is most relevant to CSSDR or adenoma detection rate (ADR) and provide benchmark data.
We analyzed 26 627 colonoscopies performed by 30 endoscopists. Clinically significant serrated polyps were defined as any sessile serrated adenoma/polyp or traditional serrated adenoma, hyperplastic polyps ≥ 5 mm in the proximal colon, or hyperplastic polyps ≥ 10 mm anywhere in the colon. Correlation of CSSDR and ADR with other simple SDRs, SDR-pathology (sessile serrated adenoma/polyp or traditional serrated adenoma), SDR-size (≥ 10 mm), and SDR-location (proximal location) was analyzed using Pearson's correlation test and Steiger's z-test.
The CSSDR was 1.7% to 13.2% (mean = 6.1%). The correlation coefficient of CSSDR/SDR-size was 0.91 (P < 0.01), which was higher than that of CSSDR/SDR-location (0.64, P < 0.01) (0.91 vs 0.61, P < 0.01). The correlation coefficient of ADR/CSSDR and ADR/SDR-location was 0.41 (P < 0.01) and 0.81 (P < 0.01), respectively. For ADR ≥ 25%, endoscopists' median screening CSSDR was 5.4%, while SDR-location and SDR-size were 10.9% and 2.2%, respectively.
Large SDR could be a simple proxy for CSSDR, in addition to proximal SDR. Large SDR and proximal SDR benchmarks of 2.2% and 10.9% may guide adequate serrated polyp detection with uniform definitions and simpler calculations.
锯齿状息肉检出率（SDR）是预防结直肠癌相关锯齿状通路的潜在质量指标。基于临床显著锯齿状息肉（CSSDR）有发展为结直肠癌前体的能力，提出了临床显著 SDR（CSSDR）。尚未研究 CSSDR 与近端 SDR 以外的其他更简单的 SDR 之间的相关性。我们旨在研究哪种更简单的 SDR 指标与 CSSDR 或腺瘤检出率（ADR）最相关，并提供基准数据。
我们分析了 30 名内镜医生进行的 26627 例结肠镜检查。临床显著锯齿状息肉定义为任何无蒂锯齿状腺瘤/息肉或传统锯齿状腺瘤、近端结肠中直径≥5mm 的增生性息肉或结肠中任何部位直径≥10mm 的增生性息肉。使用 Pearson 相关检验和 Steiger z 检验分析 CSSDR 和 ADR 与其他简单 SDR、SDR-病理（无蒂锯齿状腺瘤/息肉或传统锯齿状腺瘤）、SDR-大小（≥10mm）和 SDR-位置（近端位置）的相关性。
CSSDR 为 1.7%至 13.2%（平均值为 6.1%）。CSSDR/SDR-大小的相关系数为 0.91（P<0.01），高于 CSSDR/SDR-位置（0.64，P<0.01）（0.91 与 0.61，P<0.01）。ADR/CSSDR 和 ADR/SDR-位置的相关系数分别为 0.41（P<0.01）和 0.81（P<0.01）。对于 ADR≥25%，内镜医生的中位筛查 CSSDR 为 5.4%，而 SDR-位置和 SDR-大小分别为 10.9%和 2.2%。
除近端 SDR 外，大 SDR 也可能是 CSSDR 的简单替代指标。2.2%和 10.9%的大 SDR 和近端 SDR 基准可能会指导使用统一的定义和更简单的计算来充分检测锯齿状息肉。
