Usefulness of the Japan narrow-band imaging expert team classification system for the diagnosis of sessile serrated lesion with dysplasia/carcinoma.
Japan NBI expert team (JNET)
Narrow-band imaging (NBI)
SSL with dysplasia
Sessile serrated adenoma/polyp (SSA/P)
Sessile serrated lesion (SSL)
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
02
03
2020
accepted:
27
08
2020
pubmed:
11
9
2020
medline:
21
10
2021
entrez:
10
9
2020
Statut:
ppublish
Résumé
Sessile serrated lesion (SSL) is a colorectal polyp that has malignant potential. However, the dysplastic components within an SSL can be difficult to diagnose with conventional endoscopy, because most SSLs with dysplasia/carcinoma have subtle mucosal features. Many studies have indicated that narrow-band imaging (NBI) observations of colorectal polyps are very useful, accurate predictors of histology. We aimed to verify the usefulness of the Japan NBI Expert Team (JNET) classification system for the diagnosis of SSLs with dysplasia/carcinoma. We examined 709 endoscopically or surgically resected lesions that were pathologically diagnosed as SSL, including 647 with no dysplasia, 37 with low-grade dysplasia, 15 with high-grade dysplasia, and 10 with submucosal invasive carcinoma. We retrospectively evaluated their clinicopathologic characteristics and conventional endoscopic and magnifying NBI endoscopic findings using the JNET system. Cases in all groups were more frequently located in the proximal colon. Submucosal invasive carcinomas were significantly larger than no dysplasia and low-grade dysplasia lesions. Almost all studied lesions (96.3%) were covered with a mucus cap. Five hundred and eighty (81.8%) lesions exhibited dark spots inside the crypts, which are NBI findings' characteristic of SSL. As for the JNET classification of magnifying NBI endoscopic findings, all 709 lesions showed Type 1. Six hundred and eighteen (95.5%) SSLs with no dysplasia lesions exhibited Type 1 only, whereas 52 (83.9%) SSLs with dysplasia/carcinoma had a combination of Type 1 and Type 2A, 2B, or 3, corresponding to SSL and dysplasia/carcinoma, respectively. The JNET classification had high sensitivity (83.9%), specificity (95.5%), and overall diagnostic accuracy (94.5%) for diagnosing SSLs with dysplasia/carcinoma. Use of magnifying NBI endoscopy with the JNET classification might be useful for diagnosing SSLs with dysplasia/carcinoma. This increased awareness may also improve the recognition of SSLs with dysplasia/carcinoma.
Sections du résumé
BACKGROUND
Sessile serrated lesion (SSL) is a colorectal polyp that has malignant potential. However, the dysplastic components within an SSL can be difficult to diagnose with conventional endoscopy, because most SSLs with dysplasia/carcinoma have subtle mucosal features. Many studies have indicated that narrow-band imaging (NBI) observations of colorectal polyps are very useful, accurate predictors of histology. We aimed to verify the usefulness of the Japan NBI Expert Team (JNET) classification system for the diagnosis of SSLs with dysplasia/carcinoma.
METHODS
We examined 709 endoscopically or surgically resected lesions that were pathologically diagnosed as SSL, including 647 with no dysplasia, 37 with low-grade dysplasia, 15 with high-grade dysplasia, and 10 with submucosal invasive carcinoma. We retrospectively evaluated their clinicopathologic characteristics and conventional endoscopic and magnifying NBI endoscopic findings using the JNET system.
RESULTS
Cases in all groups were more frequently located in the proximal colon. Submucosal invasive carcinomas were significantly larger than no dysplasia and low-grade dysplasia lesions. Almost all studied lesions (96.3%) were covered with a mucus cap. Five hundred and eighty (81.8%) lesions exhibited dark spots inside the crypts, which are NBI findings' characteristic of SSL. As for the JNET classification of magnifying NBI endoscopic findings, all 709 lesions showed Type 1. Six hundred and eighteen (95.5%) SSLs with no dysplasia lesions exhibited Type 1 only, whereas 52 (83.9%) SSLs with dysplasia/carcinoma had a combination of Type 1 and Type 2A, 2B, or 3, corresponding to SSL and dysplasia/carcinoma, respectively. The JNET classification had high sensitivity (83.9%), specificity (95.5%), and overall diagnostic accuracy (94.5%) for diagnosing SSLs with dysplasia/carcinoma.
CONCLUSIONS
Use of magnifying NBI endoscopy with the JNET classification might be useful for diagnosing SSLs with dysplasia/carcinoma. This increased awareness may also improve the recognition of SSLs with dysplasia/carcinoma.
Identifiants
pubmed: 32909209
doi: 10.1007/s00464-020-07967-w
pii: 10.1007/s00464-020-07967-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4528-4538Références
Torlakovic E, Skovlund E, Snover DC, Torlakovic G, Nesland JM (2003) Morphologic reappraisal of serrated colorectal polyps. Am J Surg Pathol 27:65–81
pubmed: 12502929
doi: 10.1097/00000478-200301000-00008
Pai RK, Mäkinen MJ, Rosty C (2019) Colorectal serrated lesions and polyps. In: Nagtegaal ID, Arends MJ, Odze RD, Lam AK (eds) WHO Classification of Tumours of the Digestive System, vol 1, 5th edn. IARC Press, Lyon, pp 163–169
Kambara T, Simms LA, Whitehall VL, Spring KJ, Wynter CV, Walsh MD, Barker MA, Arnold S, McGivern A, Matsubara N, Tanaka N, Higuchi T, Young J, Jass JR, Leggett BA (2004) BRAF mutation is associated with DNA methylation in serrated polyps and cancers of the colorectum. Gut 53:1137–1144
pubmed: 15247181
pmcid: 1774130
doi: 10.1136/gut.2003.037671
O'Brien MJ, Yang S, Mack C, Xu H, Huang CS, Mulcahy E, Amorosino M, Farraye FA (2006) Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points. Am J Surg Pathol 30:1491–1501
pubmed: 17122504
doi: 10.1097/01.pas.0000213313.36306.85
Patil DT, Shadrach BL, Rybicki LA, Leach BH, Pai RK (2012) Proximal colon cancers and the serrated pathway: A systematic analysis of precursor histology and BRAF mutation status. Mod Pathol 25:1423–1431
pubmed: 22684223
doi: 10.1038/modpathol.2012.98
pmcid: 22684223
Kim YH, Kakar S, Cun L, Deng G, Kim YS (2008) Distinct CpG island methylation profiles and BRAF mutation status in serrated and adenomatous colorectal polyps. Int J Cancer 123:2587–2593
pubmed: 18798261
doi: 10.1002/ijc.23840
pmcid: 18798261
Sandmeier D, Benhattar J, Martin P, Bouzourene H (2009) Serrated polyps of the large intestine: a molecular study comparing sessile serrated adenomas and hyperplastic polyps. Histopathology 55:206–213
pubmed: 19694828
doi: 10.1111/j.1365-2559.2009.03356.x
pmcid: 19694828
Kim KM, Lee EJ, Ha S, Kang SY, Jang KT, Park CK, Kim JY, Kim YH, Chang DK, Odze RD (2011) Molecular features of colorectal hyperplastic polyps and sessile serrated adenoma/polyps from Korea. Am J Surg Pathol 35:1274–1286
pubmed: 21836485
doi: 10.1097/PAS.0b013e318224cd2e
pmcid: 21836485
Dhir M, Yachida S, Van Neste L, Glöckner SC, Jeschke J, Pappou EP, Montgomery EA, Herman JG, Baylin SB, Iacobuzio-Donahue C, Ahuja N (2011) Sessile serrated adenomas and classical adenomas: An epigenetic perspective on premalignant neoplastic lesions of the gastrointestinal tract. Int J Cancer 129:1889–1898
pubmed: 21154739
pmcid: 3206997
doi: 10.1002/ijc.25847
Murakami T, Mitomi H, Saito T, Takahashi M, Sakamoto N, Fukui N, Yao T, Watanabe S (2015) Distinct WNT/β-catenin signaling activation in the serrated neoplasia pathway and the adenoma-carcinoma sequence of the colorectum. Mod Pathol 28:146–158
pubmed: 24925057
doi: 10.1038/modpathol.2014.41
pmcid: 24925057
Jass JR, Baker K, Zlobec I, Higuchi T, Barker M, Buchanan D, Young J (2006) Advanced colorectal polyps with the molecular and morphological features of serrated polyps and adenomas: concept of a ‘fusion’ pathway to colorectal cancer. Histopathology 49:121–131
pubmed: 16879389
pmcid: 1619718
doi: 10.1111/j.1365-2559.2006.02466.x
Spring KJ, Zhao ZZ, Karamatic R, Walsh MD, Whitehall VL, Pike T, Simms LA, Young J, James M, Montgomery GW, Appleyard M, Hewett D, Togashi K, Jass JR, Leggett BA (2006) High prevalence of sessile serrated adenomas with BRAF mutations: A prospective study of patients undergoing colonoscopy. Gastroenterology 131:1400–1407
pubmed: 17101316
doi: 10.1053/j.gastro.2006.08.038
pmcid: 17101316
Carr NJ, Mahajan H, Tan KL, Hawkins NJ, Ward RL (2009) Serrated and non-serrated polyps of the colorectum: Their prevalence in an unselected case series and correlation of BRAF mutation analysis with the diagnosis of sessile serrated adenoma. J Clin Pathol 62:516–518
pubmed: 19126563
doi: 10.1136/jcp.2008.061960
pmcid: 19126563
Fujita K, Yamamoto H, Matsumoto T, Hirahashi M, Gushima M, Kishimoto J, Nishiyama K, Taguchi T, Yao T, Oda Y (2011) Sessile serrated adenoma with early neoplastic progression: A clinicopathologic and molecular study. Am J Surg Pathol 35:295–304
pubmed: 21263251
doi: 10.1097/PAS.0b013e318205df36
pmcid: 21263251
Yachida S, Mudali S, Martin SA, Montgomery EA, Iacobuzio-Donahue CA (2009) Beta-catenin nuclear labeling is a common feature of sessile serrated adenomas and correlates with early neoplastic progression after BRAF activation. Am J Surg Pathol 33:1823–1832
pubmed: 19745699
pmcid: 2788075
doi: 10.1097/PAS.0b013e3181b6da19
Powell SM, Zilz N, Beazer-Barclay Y, Bryan TM, Hamilton SR, Thibodeau SN, Vogelstein B, Kinzler KW (1992) APC mutations occur early during colorectal tumorigenesis. Nature 359:235–237
pubmed: 1528264
doi: 10.1038/359235a0
pmcid: 1528264
Miyoshi Y, Nagase H, Ando H, Horii A, Ichii S, Nakatsuru S, Aoki T, Miki Y, Mori T, Nakamura Y (1992) Somatic mutations of the APC gene in colorectal tumors: mutation cluster region in the APC gene. Hum Mol Genet 1:229–233
pubmed: 1338904
doi: 10.1093/hmg/1.4.229
pmcid: 1338904
Jass JR (2007) Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology 50:113–130
pubmed: 17204026
doi: 10.1111/j.1365-2559.2006.02549.x
pmcid: 17204026
Snover DC (2011) Update on the serrated pathway to colorectal carcinoma. Hum Pathol 42:1–10
pubmed: 20869746
doi: 10.1016/j.humpath.2010.06.002
pmcid: 20869746
Goldstein NS (2006) Small colonic microsatellite unstable adenocarcinomas and high-grade epithelial dysplasias in sessile serrated adenoma polypectomy specimens: A study of eight cases. Am J Clin Pathol 125:132–145
pubmed: 16483002
doi: 10.1309/V8Q9KDD5AJ9LNBAG
pmcid: 16483002
Bettington M, Walker N, Clouston A, Brown I, Leggett B, Whitehall V (2013) The serrated pathway to colorectal carcinoma: current concepts and challenges. Histopathology 62:367–386
pubmed: 23339363
doi: 10.1111/his.12055
pmcid: 23339363
Murakami T, Sakamoto N, Nagahara A (2019) Clinicopathological features, diagnosis, and treatment of sessile serrated adenoma/polyp with dysplasia/carcinoma. J Gastroenterol Hepatol 34:1685–1695
pubmed: 31158302
doi: 10.1111/jgh.14752
pmcid: 31158302
Murakami T, Mitomi H, Yao T, Saito T, Shibuya T, Sakamoto N, Osada T, Watanabe S (2018) Distinct histopathological characteristics in colorectal submucosal invasive carcinoma arising in sessile serrated adenoma/polyp and conventional tubular adenoma. Virchows Arch 472:383–393
pubmed: 28929387
doi: 10.1007/s00428-017-2234-8
pmcid: 28929387
Sano Y, Tanaka S, Kudo SE, Saito S, Matsuda T, Wada Y, Fujii T, Ikematsu H, Uraoka T, Kobayashi N, Nakamura H, Hotta K, Horimatsu T, Sakamoto N, Fu KI, Tsuruta O, Kawano H, Kashida H, Takeuchi Y, Machida H, Kusaka T, Yoshida N, Hirata I, Terai T, Yamano HO, Kaneko K, Nakajima T, Sakamoto T, Yamaguchi Y, Tamai N, Nakano N, Hayashi N, Oka S, Iwatate M, Ishikawa H, Murakami Y, Yoshida S, Saito Y (2016) Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc 28:526–533
pubmed: 26927367
doi: 10.1111/den.12644
pmcid: 26927367
Hashiguchi Y, Muro K, Saito Y, Ito Y, Ajioka Y, Hamaguchi T, Hasegawa K, Hotta K, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kinugasa Y, Murofushi K, Nakajima TE, Oka S, Tanaka T, Taniguchi H, Tsuji A, Uehara K, Ueno H, Yamanaka T, Yamazaki K, Yoshida M, Yoshino T, Itabashi M, Sakamaki K, Sano K, Shimada Y, Tanaka S, Uetake H, Yamaguchi S, Yamaguchi N, Kobayashi H, Matsuda K, Kotake K, Sugihara K, Japanese Society for Cancer of the Colon, and Rectum (2020) Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol 25:1–42
pubmed: 31203527
doi: 10.1007/s10147-019-01485-z
Tanaka S, Sano Y (2011) Aim to unify the narrow band imaging (NBI) magnifying classification for colorectal tumors: current status in Japan from a summary of the consensus symposium in the 79th annual meeting of the Japan Gastroenterological Endoscopy Society. Dig Endosc 23:131–139
pubmed: 21535219
doi: 10.1111/j.1443-1661.2011.01106.x
pmcid: 21535219
Kudo SE, Lambert R, Allen JI, Fujii H, Fujii T, Kashida H, Matsuda T, Mori M, Saito H, Shimoda T, Tanaka S, Watanabe H, Sung JJ, Feld AD, Inadomi JM, O'Brien MJ, Lieberman DA, Ransohoff DF, Soetikno RM, Triadafilopoulos G, Zauber A, Teixeira CR, Rey JF, Jaramillo E, Rubio CA, Van Gossum A, Jung M, Vieth M, Jass JR, Hurlstone PD (2008) Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc 68:S3–47
pubmed: 18805238
doi: 10.1016/j.gie.2008.07.052
pmcid: 18805238
Hazewinkel Y, López-Cerón M, East JE, Rastogi A, Pellisé M, Nakajima T, van Eeden S, Tytgat KM, Fockens P, Dekker E (2013) Endoscopic features of sessile serrated adenomas: validation by international experts using high-resolution white-light endoscopy and narrow-band imaging. Gastrointest Endosc 77:916–924
pubmed: 23433877
doi: 10.1016/j.gie.2012.12.018
pmcid: 23433877
Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L (2009) Association of colonoscopy and death from colorectal cancer. Ann Intern Med 150:1–8
pubmed: 19075198
doi: 10.7326/0003-4819-150-1-200901060-00306
pmcid: 19075198
Brenner H, Hoffmeister M, Arndt V, Stegmaier C, Altenhofen L, Haug U (2010) Protection from right- and left-sided colorectal neoplasms after colonoscopy: Population-based study. J Natl Cancer Inst 102:89–95
pubmed: 20042716
doi: 10.1093/jnci/djp436
Singh H, Nugent Z, Demers AA, Kliewer EV, Mahmud SM, Bernstein CN (2010) The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Gastroenterology 139:1128–1137
pubmed: 20600026
doi: 10.1053/j.gastro.2010.06.052
Sawhney MS, Farrar WD, Gudiseva S, Nelson DB, Lederle FA, Rector TS, Bond JH (2006) Microsatellite instability in interval colon cancers. Gastroenterology 131:1700–1705
pubmed: 17087932
doi: 10.1053/j.gastro.2006.10.022
Arain MA, Sawhney M, Sheikh S, Anway R, Thyagarajan B, Bond JH, Shaukat A (2010) CIMP status of interval colon cancers: Another piece to the puzzle. Am J Gastroenterol 105:1189–1195
pubmed: 20010923
doi: 10.1038/ajg.2009.699
Cooper GS, Xu F, Barnholtz Sloan JS, Schluchter MD, Koroukian SM (2012) Prevalence and predictors of interval colorectal cancers in medicare beneficiaries. Cancer 118:3044–3052
pubmed: 21989586
doi: 10.1002/cncr.26602
Rutter MD, Beintaris I, Valori R, Chiu HM, Corley DA, Cuatrecasas M, Dekker E, Forsberg A, Gore-Booth J, Haug U, Kaminski MF, Matsuda T, Meijer GA, Morris E, Plumb AA, Rabeneck L, Robertson DJ, Schoen RE, Singh H, Tinmouth J, Young GP, Sanduleanu S (2018) World endoscopy organization consensus statements on post-colonoscopy and post-imaging colorectal cancer. Gastroenterology 155:909–925.e3
pubmed: 29958856
doi: 10.1053/j.gastro.2018.05.038
Tadepalli US, Feihel D, Miller KM, Itzkowitz SH, Freedman JS, Kornacki S, Cohen LB, Bamji ND, Bodian CA, Aisenberg J (2011) A morphologic analysis of sessile serrated polyps observed during routine colonoscopy (with video). Gastrointest Endosc 74:1360–1368
pubmed: 22018553
doi: 10.1016/j.gie.2011.08.008
Boparai KS, van den Broek FJ, van Eeden S, Fockens P, Dekker E (2009) Hyperplastic polyposis syndrome: A pilot study for the differentiation of polyps by using high-resolution endoscopy, autofluorescence imaging, and narrow-band imaging. Gastrointest Endosc 70:947–955
pubmed: 19595313
doi: 10.1016/j.gie.2009.03.1172
Gurudu SR, Heigh RI, De Petris G, Heigh EG, Leighton JA, Pasha SF, Malagon IB, Das A (2010) Sessile serrated adenomas: Demographic, endoscopic and pathological characteristics. World J Gastroenterol 16:3402–3405
pubmed: 20632442
pmcid: 2904886
doi: 10.3748/wjg.v16.i27.3402
Higuchi T, Sugihara K, Jass JR (2005) Demographic and pathological characteristics of serrated polyps of colorectum. Histopathology 47:32–40
pubmed: 15982321
doi: 10.1111/j.1365-2559.2005.02180.x
Sano W, Fujimori T, Ichikawa K, Sunakawa H, Utsumi T, Iwatate M, Hasuike N, Hattori S, Kosaka H, Sano Y (2018) Clinical and endoscopic evaluations of sessile serrated adenoma/polyps with cytological dysplasia. J Gastroenterol Hepatol 33:1454–1460
pubmed: 29377243
doi: 10.1111/jgh.14099
pmcid: 29377243
Murakami T, Sakamoto N, Ritsuno H, Shibuya T, Osada T, Mitomi H, Yao T, Watanabe S (2017) Distinct endoscopic characteristics of sessile serrated adenoma/polyp with and without dysplasia/carcinoma. Gastrointest Endosc 85:590–600
pubmed: 27663716
doi: 10.1016/j.gie.2016.09.018
pmcid: 27663716
Gono K, Obi T, Yamaguchi M, Ohyama N, Machida H, Sano Y, Yoshida S, Hamamoto Y, Endo T (2004) Appearance of enhanced tissue features in narrowband endoscopic imaging. J Biomed Opt 9:568–577
pubmed: 15189095
doi: 10.1117/1.1695563
pmcid: 15189095
Machida H, Sano Y, Hamamoto Y, Muto M, Kozu T, Tajiri H, Yoshida S (2004) Narrow-band imaging in the diagnosis of colorectal mucosal lesions: A pilot study. Endoscopy 36:1094–1098
pubmed: 15578301
doi: 10.1055/s-2004-826040
pmcid: 15578301
Hirata M, Tanaka S, Oka S, Kaneko I, Yoshida S, Yoshihara M, Chayama K (2007) Evaluation of microvessels in colorectal tumors by narrow band imaging magnification. Gastrointest Endosc 66:945–952
pubmed: 17963882
doi: 10.1016/j.gie.2007.05.053
pmcid: 17963882
Hirata M, Tanaka S, Oka S, Kaneko I, Yoshida S, Yoshihara M, Chayama K (2007) Magnifying endoscopy with narrow band imaging for diagnosis of colorectal tumors. Gastrointest Endosc 65:988–995
pubmed: 17324407
doi: 10.1016/j.gie.2006.07.046
pmcid: 17324407
East JE, Suzuki N, Bassett P, Stavrinidis M, Thomas HJ, Guenther T, Tekkis PP, Saunders BP (2008) Narrow band imaging with magnification for the characterization of small and diminutive colonic polyps: Pit pattern and vascular pattern intensity. Endoscopy 40:811–817
pubmed: 18828077
doi: 10.1055/s-2008-1077586
pmcid: 18828077
Wada Y, Kashida H, Kudo SE, Misawa M, Ikehara N, Hamatani S (2010) Diagnostic accuracy of pit pattern and vascular pattern analyses in colorectal lesions. Dig Endosc 22:192–199
pubmed: 20642608
doi: 10.1111/j.1443-1661.2010.00983.x
pmcid: 20642608
Kobayashi S, Yamada M, Takamaru H, Sakamoto T, Matsuda T, Sekine S, Igarashi Y, Saito Y (2019) Diagnostic yield of the Japan NBI Expert Team (JNET) classification for endoscopic diagnosis of superficial colorectal neoplasms in a large-scale clinical practice database. United European Gastroenterol J 7:914–923
pubmed: 31428416
pmcid: 6683640
doi: 10.1177/2050640619845987
Komeda Y, Kashida H, Sakurai T, Asakuma Y, Tribonias G, Nagai T, Kono M, Minaga K, Takenaka M, Arizumi T, Hagiwara S, Matsui S, Watanabe T, Nishida N, Chikugo T, Chiba Y, Kudo M (2017) Magnifying narrow band imaging (NBI) for the diagnosis of localized colorectal lesions using the Japan NBI Expert Team (JNET) Classification. Oncology 93:49–54
pubmed: 29258091
doi: 10.1159/000481230
pmcid: 29258091
Iwatate M, Sano Y, Tanaka S, Kudo SE, Saito S, Matsuda T, Wada Y, Fujii T, Ikematsu H, Uraoka T, Kobayashi N, Nakamura H, Hotta K, Horimatsu T, Sakamoto N, Fu KI, Tsuruta O, Kawano H, Kashida H, Takeuchi Y, Machida H, Kusaka T, Yoshida N, Hirata I, Terai T, Yamano HO, Nakajima T, Sakamoto T, Yamaguchi Y, Tamai N, Nakano N, Hayashi N, Oka S, Ishikawa H, Murakami Y, Yoshida S, Saito Y, Expert JNBI (2018) Validation study for development of the Japan NBI Expert Team classification of colorectal lesions. Dig Endosc 30:642–651
pubmed: 29603399
doi: 10.1111/den.13065
pmcid: 29603399
Sumimoto K, Tanaka S, Shigita K, Hirano D, Tamaru Y, Ninomiya Y, Asayama N, Hayashi N, Oka S, Arihiro K, Yoshihara M, Chayama K (2017) Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Gastrointest Endosc 85:816–821
pubmed: 27460392
doi: 10.1016/j.gie.2016.07.035
pmcid: 27460392
Yamashina T, Takeuchi Y, Uedo N, Aoi K, Matsuura N, Nagai K, Matsui F, Ito T, Fujii M, Yamamoto S, Hanaoka N, Higashino K, Ishihara R, Tomita Y, Iishi H (2015) Diagnostic features of sessile serrated adenoma/polyps on magnifying narrow band imaging: a prospective study of diagnostic accuracy. J Gastroenterol Hepatol 30:117–123
pubmed: 25088839
doi: 10.1111/jgh.12688
pmcid: 25088839
Yamada M, Sakamoto T, Otake Y, Nakajima T, Kuchiba A, Taniguchi H, Sekine S, Kushima R, Ramberan H, Parra-Blanco A, Fujii T, Matsuda T, Saito Y (2015) Investigating endoscopic features of sessile serrated adenomas/polyps by using narrow-band imaging with optical magnification. Gastrointest Endosc 82:108–117
pubmed: 25840928
doi: 10.1016/j.gie.2014.12.037
pmcid: 25840928
Uraoka T, Higashi R, Horii J, Harada K, Hori K, Okada H, Mizuno M, Tomoda J, Ohara N, Tanaka T, Chiu HM, Yahagi N, Yamamoto K (2015) Prospective evaluation of endoscopic criteria characteristic of sessile serrated adenomas/polyps. J Gastroenterol 50:555–563
pubmed: 25270966
doi: 10.1007/s00535-014-0999-y
pmcid: 25270966