Endoscopic prediction of deep submucosal invasive carcinoma: validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification

Hayashi, Nana, Tanaka, Shinji, Hewett, David G., Kaltenbach, Tonya R., Sano, Yasushi, Ponchon, Thierry, Saunders, Brian P., Rex, Douglas K. and Soetikno, Roy M. (2013) Endoscopic prediction of deep submucosal invasive carcinoma: validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification. Gastrointestinal Endoscopy, 78 4: 625-632. doi:10.1016/j.gie.2013.04.185


Author Hayashi, Nana
Tanaka, Shinji
Hewett, David G.
Kaltenbach, Tonya R.
Sano, Yasushi
Ponchon, Thierry
Saunders, Brian P.
Rex, Douglas K.
Soetikno, Roy M.
Title Endoscopic prediction of deep submucosal invasive carcinoma: validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification
Journal name Gastrointestinal Endoscopy   Check publisher's open access policy
ISSN 0016-5107
1097-6779
Publication date 2013-10
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.gie.2013.04.185
Open Access Status
Volume 78
Issue 4
Start page 625
End page 632
Total pages 8
Place of publication Philadelphia, United States
Publisher Mosby
Collection year 2014
Language eng
Formatted abstract
Background
A simple endoscopic classification to accurately predict deep submucosal invasive (SM-d) carcinoma would be clinically useful.

Objective
To develop and assess the validity of the NBI international colorectal endoscopic (NICE) classification for the characterization of SM-d carcinoma.

Design
The study was conducted in 4 phases: (1) evaluation of endoscopic differentiation by NBI-experienced colonoscopists; (2) extension of the NICE classification to incorporate SM-d (type 3) by using a modified Delphi method; (3) prospective validation of the individual criteria by inexperienced participants, by using high-definition still images without magnification of known histology; and (4) prospective validation of the individual criteria and overall classification by inexperienced participants after training.

Setting
Japanese academic unit.

Main Outcome Measurements
Performance characteristics of the NICE criteria (phase 3) and overall classification (phase 4) for SM-d carcinoma; sensitivity, specificity, predictive values, and accuracy.

Results
We expanded the NICE classification for the endoscopic diagnosis of SM-d carcinoma (type 3) and established the predictive validity of its individual components. The negative predictive values of the individual criteria for diagnosis of SM-d carcinoma were 76.2% (color), 88.5% (vessels), and 79.1% (surface pattern). When any 1 of the 3 SM-d criteria was present, the sensitivity was 94.9%, and the negative predictive value was 95.9%. The overall sensitivity and negative predictive value of a global, high-confidence prediction of SM-d carcinoma was 92%. Interobserver agreement for an overall SM-d carcinoma prediction was substantial (kappa 0.70).

Limitations
Single Japanese center, use of still images without prospective clinical evaluation.

Conclusion
The NICE classification is a valid tool for predicting SM-d carcinomas in colorectal tumors.
Keyword Diminutive colonic polyps
Definition white light
Optical magnification
Pit pattern
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 47 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 58 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 13 Oct 2013, 00:07:36 EST by System User on behalf of School of Medicine