VALUATION OF JNET AND KUDO CLASSIFICATIONS COMPARED WITH HISTOPATHOLOGY IN COLORECTAL POLYPS

Nguyễn Công Long1,2, Hoàng Văn Chương1,, Nguyễn Hoài Nam1,2, Đồng Thị Thu Thảo1, Trần Thị Tân1, Phạm Bình Nguyên1,2, Nguyễn Thế Phương1,3, Nguyễn Thế Phương1,3, Trần Tuấn Việt1, Đỗ Anh Giang1, Kiều Văn Tuấn1
1 Department of Gastroenterology and Hepatology, Bach Mai Hospital
2 University of Medicine and Pharmacy, Vietnam National University, Hanoi
3 Hanoi Medical University

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Abstract

Background: Colorectal polyp is a common disease and has risks of malignancy. White light endoscopy can help to detect polyps, but it is still limited in accurately predicting polyp histopathology. Advanced endoscopic techniques have been developed to help observe in more detail the mucosal surface, submucosal vascular structure, thereby accurately predicting polyp histopathology results, supporting accurate treatment. Objectives: To compare the JNET classification on narrow band endoscopy (NBI) and the Kudo classification on endoscopic staining with indigocarmin with histopathological results in colorectal polyps. Methods: descriptive study evaluating diagnostic tests. Results: Among 2000 patients undergoing colonoscopy to screen polyp and colorectal cancer in Gastroenterology and Hepatology Center, Bạch Mai hospital, the study obtained 339 patients with a total of 490 polyp which were removed by endoscopic therapy or surgery  from 1/2021 to 4/2022. Of 490 polyps, there were 408 neoplastic polyps (386 adenomatous polyps and 22 cancerous polyps). The chromoendoscopy have high sensitivity and accuracy when comparing with histopathological results of polyps. Sensitivity and accuracy for the diagnosis of neoplastic polyps of NBI chromoendoscopy are 93.9%, 88.4%, respectively, equivalent to 92.2% indigo carmin chromoendoscopy, respectively. 89.4%, however, the specificity of 61.0% is lower than that of  indigo carmine staining endoscopy of 75.6%. Combining the two methods did not increase the sensitivity by 91.7%, but increased the specificity in diagnosis by 78%. Conclusion: The JNET, Judo classification has the ability to help predict the histopathological results of colorectal polyps.

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References

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