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Fustà-Novell X, González-Martínez JP, Esquius M, De La Torre N, Rosiñol Ò, Sáez-Galdeano O, Creus-Vila L. A kidney transplant patient with multiple ulcerated nodules on the buttocks. Int J Dermatol 2020; 60:e164-e165. [PMID: 32783187 DOI: 10.1111/ijd.15119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Xavier Fustà-Novell
- Department of Dermatology, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | - José Pedro González-Martínez
- Department of Internal Medicine, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | - Mireia Esquius
- Department of Dermatology, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | - Noèlia De La Torre
- Department of Pathology, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | - Òria Rosiñol
- Department of Pathology, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | - Onofre Sáez-Galdeano
- Department of Plastic Surgery, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
| | - Lidia Creus-Vila
- Department of Dermatology, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain
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Puig I, López-Cerón M, Arnau A, Rosiñol Ò, Cuatrecasas M, Herreros-de-Tejada A, Ferrández Á, Serra-Burriel M, Nogales Ó, Vida F, de Castro L, López-Vicente J, Vega P, Álvarez-González MA, González-Santiago J, Hernández-Conde M, Díez-Redondo P, Rivero-Sánchez L, Gimeno-García AZ, Burgos A, García-Alonso FJ, Bustamante-Balén M, Martínez-Bauer E, Peñas B, Pellise M. Accuracy of the Narrow-Band Imaging International Colorectal Endoscopic Classification System in Identification of Deep Invasion in Colorectal Polyps. Gastroenterology 2019; 156:75-87. [PMID: 30296432 DOI: 10.1053/j.gastro.2018.10.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 09/19/2018] [Accepted: 10/02/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS T1 colorectal polyps with at least 1 risk factor for metastasis to lymph node should be treated surgically and are considered endoscopically unresectable. Optical analysis, based on the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification system, is used to identify neoplasias with invasion of the submucosa that require endoscopic treatment. We assessed the accuracy of the NICE classification, along with other morphologic characteristics, in identifying invasive polyps that are endoscopically unresectable (have at least 1 risk factor for metastasis to lymph node). METHODS We performed a multicenter, prospective study of data collected by 58 endoscopists, from 1634 consecutive patients (examining 2123 lesions) at 17 university and community hospitals in Spain from July 2014 through June 2016. All consecutive lesions >10 mm assessed with narrow-band imaging were included. The primary end point was the accuracy of the NICE classification for identifying lesions with deep invasion, using findings from histology analysis as the reference standard. Conditional inference trees were fitted for the analysis of diagnostic accuracy. RESULTS Of the 2123 lesions analyzed, 89 (4.2%) had features of deep invasion and 91 (4.3%) were endoscopically unresectable. The NICE classification system identified lesions with deep invasion with 58.4% sensitivity (95% CI, 47.5-68.8), 96.4% specificity (95% CI, 95.5-97.2), a positive-predictive value of 41.6% (95% CI, 32.9-50.8), and a negative-predictive value of 98.1% (95% CI, 97.5-98.7). A conditional inference tree that included all variables found the NICE classification to most accurately identify lesions with deep invasion (P < .001). However, pedunculated morphology (P < .007), ulceration (P = .026), depressed areas (P < .001), or nodular mixed type (P < .001) affected accuracy of identification. Results were comparable for identifying lesions that were endoscopically unresectable. CONCLUSIONS In an analysis of 2123 colon lesions >10 mm, we found the NICE classification and morphologic features identify those with deep lesions with >96% specificity-even in non-expert hands and without magnification. ClinicalTrials.gov number NCT02328066.
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Affiliation(s)
- Ignasi Puig
- Digestive Diseases Department, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain.
| | - María López-Cerón
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Anna Arnau
- Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | - Òria Rosiñol
- Pathology Department, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | - Miriam Cuatrecasas
- Pathology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain; Banc de Tumors, Biobanc Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Alberto Herreros-de-Tejada
- Gastroenterology Department, Research Institute Segovia Arana, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Ángel Ferrández
- Digestive Diseases Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Biomedical Research Networking Center in Hepatic and Digestive Diseases, Madrid, Spain
| | - Miquel Serra-Burriel
- Center for Research in Health and Economics, Universitat Pompeu Fabra, Barcelona, Spain
| | - Óscar Nogales
- Digestive Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Francesc Vida
- Digestive Diseases Department, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | - Luisa de Castro
- Digestive Diseases Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Jorge López-Vicente
- Digestive Diseases Department, Hospital Universitario de Móstoles, Madrid, Spain
| | - Pablo Vega
- Digestive Diseases Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Jesús González-Santiago
- Digestive Diseases Department, Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain
| | - Marta Hernández-Conde
- Gastroenterology Department, Research Institute Segovia Arana, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Pilar Díez-Redondo
- Digestive Diseases Department, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Liseth Rivero-Sánchez
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | | | - Aurora Burgos
- Digestive Diseases Department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Marco Bustamante-Balén
- Digestive Diseases Department, Hospital Universitario y Politécnico de La Fe, Valencia, Spain
| | - Eva Martínez-Bauer
- Digestive Diseases Department, Corporació Sanitària Parc Taulí, Barecelon, Spain
| | - Beatriz Peñas
- Digestive Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Maria Pellise
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Biomedical Research Networking Center in Hepatic and Digestive Diseases, Madrid, Spain
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