CONCORDANCE AND ITS ASSOCIATED FACTORS BETWEEN ENDOSCOPIC AND PATHOLOGIC DIAGNOSIS IN PATIENTS WITH SUSPECTED SESSILE SERRATED ADENOMA/POLYP

Aims:

Sessile serrated adenoma/polyp (SSA/P) are known to be precancerous lesions with difficult detection. Endoscopic features of SSA/P are well presented in NICE and WASP classification, but they were often inconsistent with pathologic results. We aimed to evaluate the concordance and its associated factors between endoscopic and pathologic diagnosis in patients with suspected SSA/P.

Methods:

Among patients with endoscopic resection from January 2015 to June 2018 in PNUYH, 129 patients (175 lesions) with suspected SSA/P and ≥10 mm size were enrolled. We retrospectively evaluated clinical and endoscopic findings, pathologic diagnosis in these patients.

Results:

Concordance between endoscopic and pathologic diagnosis of SSA/P was 33.7% (59/175). SSA/Ps showed a significant difference in size (p < 0.0001), shape (p < 0.0001), diffuse nodular surface (p < 0.012), focal nodular elevation (p < 0.023), depression (p < 0.012), ≥2 WASP criteria (p < 0.001), NICE type (p < 0.002), Kudo pit pattern (p < 0.0001) compared to hyperplastic polyps.

Conclusions:

Our results show that discrepancy between endoscopy and pathology in diagnosis of SSA/P was high. Large size, polypoid shape, irregular surface patterns, NICE type 2 and Kudo III/IV pit pattern can be helpful in endoscopic diagnosis of SSA/P. For overcome of this discrepancy, communication with pathologist and systematic endoscopic evaluation should be needed.