A107 WHAT SIZE CUT-OFF LEVEL SHOULD BE USED TO IMPLEMENT OPTICAL POLYP DIAGNOSIS?

作者：Mahsa Taghiakbari, Heiko Pohl, Roupen Djinbachian, J M Anderson, D Metellus, Alan Barkun, Mickaël Bouin, Daniel von Renteln · 发表于：Journal of the Canadian Association of Gastroenterology · 年份：2022 · DOI：10.1093/jcag/gwab049.106 · 研究领域：Breast Lesions and Carcinomas

Abstract Background The risk of advanced pathology and potential mismanagement increases with polyp size while performing optical diagnosis. We hypothesized that a lower polyp size cut-off (e.g., 1–3 mm) would be associated with a lower risk of misclassifying advanced neoplasia or even cancer when using optical diagnosis. Aims This study aimed to evaluate the proportion of patients undergoing inadequate surveillance intervals associated with different size cut-offs when using optical diagnosis. Methods In a post-hoc analysis of three prospective studies, the use of optical diagnosis was evaluated for three polyp size groups: 1–3, 1–5, and 1–10 mm. The primary outcome was the proportion of patients in which advanced adenomas were found and optical diagnosis resulted in delayed surveillance in each group. Secondary outcomes included agreements between surveillance intervals based on high-confidence optical diagnosis and pathology outcomes, reduction in histopathological examinations, and proportion of patients who could receive an immediate surveillance recommendation. Results We included 3374 patients (7291 polyps ≤10 mm) undergoing complete colonoscopies (median age 66.0 years, 75.2% male, 29.6% for screening). Among polyp sized 1–3 mm, 1–5 mm, and 1–10 mm, 0.5%, 0.6%, and 1.2% of polyps, respectively, were found to have advanced pathology ( P <.0001). The percentage of patients with advanced adenomas and either 2- or 7- year delayed surveillance intervals (n=79) was 3...