Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Dekker, Evelien; Houwen, Britt B S L; Puig, Ignasi; Bustamante-Balén, Marco; Coron, Emmanuel; Dobru, Daniela; Kuvaev, Roman; Neumann, Helmut; Johnson, Gavin; Pimentel‐Nunes, Pedro; Sanders, David S.; Dinis-Ribeiro, Mário; Arvanitakis, Marianna; Ponchon, Thierry; East, James E.; Bisschops, Raf

doi:10.1055/a-1264-2634

Cited by 28 publications

(30 citation statements)

References 55 publications

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“…However, the ASGE position paper emphasized that optical diagnosis should be performed by adequately trained, monitored, and audited endoscopists to increase the accuracy of optical diagnosis and the proportion of high confidence histology predictions [6,10,11]. The ESGE considers training in optical diagnosis as an important prerequisite for the implementation of IEE and recommends the use of validated classification systems to support the use of optical diagnosis with advanced endoscopic imaging, along with sufficient photodocumentation [9,12].…”

Section: Introductionmentioning

confidence: 99%

The location-based resect and discard strategy for diminutive colorectal polyps: a prospective clinical study

et al. 2021

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Background Clinical implementation of the resect-and-discard strategy has been difficult because optical diagnosis is highly operator dependent. This prospective study aimed to evaluate a resect-and-discard strategy that is not operator dependent. Methods The study evaluated a resect-and-discard strategy that uses the anatomical polyp location to classify colonic polyps into non-neoplastic or low risk neoplastic. All rectosigmoid diminutive polyps were considered hyperplastic and all polyps located proximally to the sigmoid colon were considered neoplastic. Surveillance interval assignments based on these a priori assumptions were compared with those based on actual pathology results and on optical diagnosis. The primary outcome was ≥ 90 % agreement with pathology in surveillance interval assignment. Results 1117 patients undergoing complete colonoscopy were included and 482 (43.1 %) had at least one diminutive polyp. Surveillance interval agreement between the location-based strategy and pathological findings using the 2020 US Multi-Society Task Force guideline was 97.0 % (95 % confidence interval [CI] 0.96–0.98), surpassing the ≥ 90 % benchmark. Optical diagnoses using the NICE and Sano classifications reached 89.1 % and 90.01 % agreement, respectively (P < 0.001), and were inferior to the location-based strategy. The location-based resect-and-discard strategy allowed a 69.7 % (95 %CI 0.67–0.72) reduction in pathology examinations compared with 55.3 % (95 %CI 0.52–0.58; NICE and Sano) and 41.9 % (95 %CI 0.39–0.45; WASP) with optical diagnosis. Conclusion The location-based resect-and-discard strategy achieved very high surveillance interval agreement with pathology-based surveillance interval assignment, surpassing the ≥ 90 % benchmark and outperforming optical diagnosis in surveillance interval agreement and the number of pathology examinations avoided.

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Section: Introductionmentioning

confidence: 99%

The location-based resect and discard strategy for diminutive colorectal polyps: a prospective clinical study

et al. 2021

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“…In order to prevent missing significant lesions, strategies are being developed to improve early detection of upper GI malignancy by implementing key performance indicators for upper GI endoscopy similar to colonoscopy, such as a thoroughly documented systematic endoscopic examination within a minimal procedure time [25,26]. Moreover, new techniques may help in increasing upper GI malignancy detection rates such as artificial intelligence that could potentially augment the endoscopic detection rate of relevant endoscopic findings [27].…”

Section: Discussionmentioning

confidence: 99%

The yield of upper gastrointestinal endoscopy in patients below 60 years and without alarm symptoms presenting with dyspepsia

Theunissen

Lantinga

Borg

et al. 2021

Scandinavian Journal of Gastroenterology

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Background and aims: Upper gastrointestinal (GI) endoscopy is frequently performed in patients with upper abdominal symptoms. Although guidelines recommend withholding an endoscopy in the absence of alarm symptoms, dyspeptic symptoms remain a predominant indication for endoscopy. We aimed to investigate the yield of upper GI endoscopy in patients with low-risk dyspeptic symptoms. Methods: We conducted an analysis in a prospectively maintained endoscopy reporting database. We collected the results of all upper GI endoscopy procedures between 2015 and 2019 that was performed in adult patients aged <60 years with dyspeptic symptoms. Patients with documented alarm symptoms were excluded. We categorized endoscopic findings into major and minor endoscopic findings. Results: We identified 26,440 patients with dyspeptic symptoms who underwent upper GI endoscopy. A total of 13,978 patients were considered low-risk and included for analysis (median age 46 years, interquartile range (IQR) [36-53], 62% female). In 11,353 patients (81.2%), no endoscopic abnormalities were detected. Major endoscopic findings were seen in 513 patients (3.7%) and minor endoscopic findings in 2178 patients (15.6%). Endoscopic findings indicative of upper GI cancer were reported in 47 patients (0.3%), including 16 (0.1%) oesophageal, 28 (0.2%) gastric and 5 (0.04%) duodenal lesions. Despite an initial unremarkable endoscopy result, 1015 of 11,353 patients (8.9%) underwent a followup endoscopy after a median of 428 days . This did not lead to the additional identification of malignancy. Conclusions: The yield of upper GI endoscopy in low-risk (<60 years, no alarm symptoms) patients with dyspepsia is very limited. This study further supports a restrictive use of upper GI endoscopy in these patients.

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“…Reflux disease is associated with an increased risk of esophagitis, esophageal strictures, Barrett esophagus, and esophageal adenocarcinoma, and it has the similar symptoms to EC [17,18] . Using endoscopy can distinguish EC from reflux disease, though some patients refuse this way to check their esophagus [19] .As a result, a blood biomarker which can help to diagnose EC from reflux disease come to be important.…”

Section: Discussionmentioning

confidence: 99%

Study on the Value of C1q in the Diagnosis of Esophageal Cancer

Cai¹,

Li²,

Chen³

et al. 2021

Preprint

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Background: Esophageal cancer was hardly diagnosed in early stage, and more potential biomarkers should be found. Methods: 252 patients and normal controls which recruited in Renmin Hospital of Wuhan University, were divided into esophageal carcinoma group (105 cases), disease control group (75 cases) and the control group of healthy people (72 cases). Moreover, TISIDB and GEPIA databases were used to investigate the different expression of EC and normal tissues, and explore the roles of C1q in tumor-immune system interactions in EC. Results: The concentration of serum C1q in EC group is 196.8(180~219.4) mg/L, which is higher than the level of DC [178.10(153.70~200.85) mg/L]and HC [183.00(167.75~201.00) mg/L] (P<0.05). A higher expression level of C1q was observed in Ⅲ and Ⅳ grades [214(192~237.3) mg/ml] than grades Ⅰ and Ⅱ [180.95(172.03~193.85) mg/L] (P<0.05). C1q was positively correlated with eosinophils, active CD8 T cells, myeloid derived suppressor cells, natural killer cells, monocytes and macrophages (r = 0.373; r = 0.659; r = 0.846; r = 0.760; r = 0.499; r = 0.757; P<0.05). Conclusion: The concentrations of C1q increased in EC and related to the severity of EC, which had potential value of diagnosis of EC. There were correlations in C1q and tumor-infiltrating lymphocytes.

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Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Cited by 28 publications

References 55 publications

The location-based resect and discard strategy for diminutive colorectal polyps: a prospective clinical study

The location-based resect and discard strategy for diminutive colorectal polyps: a prospective clinical study

The yield of upper gastrointestinal endoscopy in patients below 60 years and without alarm symptoms presenting with dyspepsia

Study on the Value of C1q in the Diagnosis of Esophageal Cancer

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