Original articleClinical endoscopyDiagnostic performance of Japan NBI Expert Team classification for differentiation among noninvasive, superficially invasive, and deeply invasive colorectal neoplasia
Section snippets
Methods
This study included 2933 consecutive cases of colorectal lesions that had been endoscopically or surgically resected. A total of 1901 patients were enrolled; 1351 patients (71.1%) had 1 lesion, 314 patients (16.5%) had 2 lesions, 132 patients (6.9%) had 3 lesions, and 104 patients (5.5%) had 4 or more lesions. All lesions were assumed to be independent observations for the purpose of statistical analysis. Each case was examined by NBI magnifying observation at the Department of Endoscopy of
Relationships between the JNET classification and histologic findings for each gross type
The results of NBI magnifying endoscopic diagnoses for all 2933 lesions using the JNET classification are shown in Table 1. According to the Paris classification, 2114 of the 2933 lesions were categorized as polypoid lesions (0-Is and 0-Ip) and the remaining 819 as superficial lesions (0-IIa, 0-IIb, and 0-IIc).
The 2114 polypoid-type lesions consisted of 57 HP/SSP lesions, 1435 LGD lesions, 431 HGD lesions, 50 SM-s carcinoma lesions, and 141 SM-d carcinoma lesions (Table 2). Histologically, 98%
Discussion
In general, there is a consensus in Japan that LGD, HGD, and SM-s carcinoma are considered to be appropriate for endoscopic resection.32, 33 Additionally, SM-d carcinoma should be surgically resected because of the possibility of lymph node metastasis. As a principle, en bloc resection is essential for carcinoma to obtain a precise histologic diagnosis.33, 34 Detailed histologic information can only be acquired from a complete specimen, and having this information enables us to make decisions
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Research support for this study was provided to Shinji Tanaka by a Grant-in-Aid from the Japan Agency for Medical Research and Development, AMED (15ck0106102h0102).