Abstract
Aims: We assessed the diagnostic performance of the Narrow-Band Imaging (NBI) International Colorectal Endoscopic Classification (NICE) and the Japan NBI Expert Team classification (JNET) in predicting histological outcomes of colorectal lesions. We aimed to compare their accuracy, particularly in identifying high-grade colorectal lesions (including high-grade adenomas, intramucosal carcinomas, T1 and T2 carcinomas).
Methods: This was a prospective study involving 211 patients (130 men, mean age 60 years) who underwent colonoscopy with endoscopic resection of advanced colorectal neoplasia (lesions ≥ 10 mm). Lesions were classified using both NICE and JNET criteria, and final histopathological results were used for comparison.
Results: Of the 257 lesions analyzed, the NICE classification demonstrated higher accuracy, correctly classifying 93.8% of lesions compared to 77.4% with JNET. Specifically, the sensitivity and positive predictive value (PPV) of NICE 2 for high-grade lesions were 100% and 24.4%, respectively. In comparison, JNET 2B had a sensitivity of 54.5% and a PPV of 52.2% for high-grade lesions.
Conclusion: The NICE classification shows higher sensitivity for high-grade colorectal lesions (HGD adenomas, intramucosal carcinomas, T1 and T2 carcinomas), whereas the JNET classification, with a positive predictive value for high-grade lesions nearly double that of NICE, is more favourable for guiding therapy decisions.
Trial Registration
clinicaltrials.gov identifier: NCT05929365