ObjectiveTo compare the diagnostic value of NICE typing under water injection and gas injection colonoscopy plus non-magnifying narrow-band imaging (NBI) in small colorectal polyps.
MethodsA total of 449 small colorectal polyps were enrolled in this study.Among them, 176 cases were found by water injection colonoscopy(water injection group), and 273 cases were found by gas injection colonoscopy(gas injection group).Each lesion was observed by non-magnifying NBI, and the histology was predicted and compared according to NICE typing system.
ResultsThere was no statistically significant difference in the examination results in the colorectal adenoma detection rate between the two groups(P>0.05), and the detection rate of flat polyps in the water injection group was higher than that in the gas injection group(P < 0.05).Experienced endoscopists had a high consistency in the diagnosis results of NICE typing(κ=0.807).The sensitivity, specificity and accuracy of NICE typing under non-magnifying NBI in the water injection group and the gas injection group were 97.0%(128/132), 81.8%(36/44), 94.3%(166/176) and 98.6%(216/219), 72.0%(39/54) and 93.4%(255/273), respectively.For novice endoscopists, the sensitivity, specificity and accuracy of NICE typing diagnosis under non-magnifying NBI in water injection group and gas injection group were 51.5%(68/132), 72.7% (32/44), 56.8% (100/176), 46.1%(101/219), 63.0%(34/54), 49.5%(135/273), respectively.The agreement of highly experienced endoscopists and novice endoscopists was low in two groups respectively(κ=0.199, 0.076).
ConclusionsBetween whatever water or gas injection colonoscopy, NICE typing under non-magnifying NBI is effective in distinguishing neoplastic from non-neoplastic small colorectal polyps for highly experienced endoscopists, which has high diagnostic value and is instructive for treatment strategy of small colorectal polyps in ambulatory ward.
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