Beukema Koen Robert, Simmering Jaimy A, Brusse-Keizer Marjolein, John Sneha, Quispel Rutger, Mensink Peter B
Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, The Netherlands.
Technical Medical Center, University of Twente, Enschede, The Netherlands.
Clin Endosc. 2022 Jul;55(4):540-548. doi: 10.5946/ce.2022.017. Epub 2022 Jul 28.
BACKGROUND/AIMS: Colorectal polyps are removed to prevent progression to colorectal cancer. Polyp size is an important factor for risk stratification of malignant transformation. Endoscopic size estimation correlates poorly with pathological reports and several factors have been suggested to influence size estimation. We aimed to gain insight into the factors influencing endoscopic polyp size estimation.
Images of polyps in an artificial model were obtained at 1, 3, and 5 cm from the colonoscope's tip. Participants were asked to estimate the diameter and volume of each polyp.
Fifteen endoscopists from three large-volume centers participated in this study. With an intraclass correlation coefficient of 0.66 (95% confidence interval [CI], 0.62-0.71) for diameter and 0.56 (95% CI, 0.50-0.62) for volume. Polyp size estimated at 3 cm from the colonoscope's tip yielded the best results. A lower distance between the tip and the polyp was associated with a larger estimated polyp size.
Correct endoscopic estimation of polyp size remains challenging. This finding can affect size estimation skills and future training programs for endoscopists.
背景/目的：切除结直肠息肉以预防进展为结直肠癌。息肉大小是恶性转化风险分层的重要因素。内镜下大小估计与病理报告的相关性较差，并且已提出几个因素会影响大小估计。我们旨在深入了解影响内镜下息肉大小估计的因素。
在距结肠镜尖端1、3和5厘米处获取人工模型中息肉的图像。要求参与者估计每个息肉的直径和体积。
来自三个大容量中心的15名内镜医师参与了本研究。直径的组内相关系数为0.66（95%置信区间[CI]，0.62 - 0.71），体积的组内相关系数为0.56（95%CI，0.50 - 0.62）。在距结肠镜尖端3厘米处估计的息肉大小产生了最佳结果。尖端与息肉之间的距离越短，估计的息肉大小越大。
正确的内镜下息肉大小估计仍然具有挑战性。这一发现可能会影响内镜医师的大小估计技能和未来的培训计划。
