Magnifying colonoscopy:: interobserver agreement in the assessment of colonic pit patterns and its correlation with histopathological findings
Magnifying colonoscopy:: interobserver agreement in the assessment of colonic pit patterns and its correlation with histopathological findings
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DOI：
10.1007/s00384-007-0336-5
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发表时间：
2007-11-01
影响因子：
2.8
通讯作者：
Camara Lopes, Luiz H.
中科院分区：
文献类型：
--
作者：
Andrade Zanoni, Esdras Camargo;Cutait, Raul;Camara Lopes, Luiz H.
背景和研究目的放大结肠镜检查（MC）被认为是鉴别诊断肿瘤性和非肿瘤性病变的一种辅助手段。本研究评估interobserver协议的经验丰富的内镜学家在结肠小坑模式的评估，通过工藤的分类和相关的形态学方面与组织病理学findings.Materials和方法A共213放大chromodendoscopic结肠病变的图片收集了161例连续的患者，并提交给三个独立的观察者谁表示意见占主导地位的小坑模式。结果Kappa统计分析显示，三位观察者在小凹方面的总体一致性指数为0.561。根据结肠小凹形态诊断预测组织病理学的准确性为84%，敏感性为91.4%，特异性为67.2%，阳性预测值为86.6%，阴性预测值为79.3%。结论虽然结肠小凹形态的观察者间重复性较好，但不能用MC代替组织病理学分析。因为它不能以必要的安全性区分肿瘤性和非肿瘤性病变。
Background and study aims Magnifying colonoscopy (MC) is recognized as an aid to the differential diagnosis between neoplastic and nonneoplastic lesions. This study evaluated interobserver agreement of experienced endoscopists in the assessment of colonic pit patterns through the Kudo's classification and correlated morphological aspects with histopathological findings.Materials and methods A total of 213 magnification chromoendoscopic pictures of colonic lesions were collected from 161 consecutive patients and presented to three independent observers who expressed opinion about predominant pit pattern. All lesions were excised and sent for histopathological study.Results Kappa statistics showed that the general agreement index with respect to the aspects of the pits was good among the three observers (0.561). Regarding prediction of histopathology according to the pit pattern diagnosis, overall accuracy was 84%, sensitivity was 91.4%, specificity was 67.2%, positive predictive value was 86.6%, and negative predictive value was 79.3%.Conclusion Although the interobserver reproducibility of the colonic pit pattern is good for experienced endoscopists, MC must not be used to replace the histopathological analysis, since it does not differentiate with the necessary safety neoplastic from nonneoplastic lesions.