Yadan Wang, Boyang Huang, Jing Wu, Chunmei Guo, Canghai Wang, Hui Su, Hong Liu, Miaomiao Wang, Jing Wang, Li Li, Pengpeng Ding, Mingming Meng
Background and aims: No single endoscopic feature can reliably predict the pathological nature of Colorectal Tumors (CRTs). We aimed to establish and validate a simple online calculator to predict the pathological nature of CRTs based on white light endoscopy.
Methods: This is a single center study. During identification stage, 530 consecutive patients with CRTs were enrolled from January 2015 to December 2021 as the derivation group. Logistic regression analysis was performed. A novel online calculator to predict the pathological nature of CRTs based on white light image was established and verified internally. During validation stage, two series of 110 images obtained using white light endoscopy were distributed to 10 endoscopists (five Highly Experienced Endoscopists (HEEs) and five Less Experienced Endoscopists (LEEs) for external validation, before and after systematic training.
Results: A total of 750 patients were included, with an average age of 63.6 ± 10.4 year-old. Early Colorectal Cancer (ECRC) was detected in 351 (46.8%) patients. Tumor size, left semicolon, rectum, acanthosis, depression and an uneven surface were independent risk factors for ECRC. The C-index of ECRC calculator prediction modelw as 0.906 (p=0.225, Hosmer-Lemeshow test). For the LEEs, significant improvement was made in the sensitivity, specificity and accuracy (57.6% versus 75.5%; 72.3% versus 82.4%; 64.2% versus 80.2%; p<0.05), respectively, after the training with ECRC online calculator prediction model.
Conclusion: A novel online calculator including tumor size, location, acanthosis, depression and uneven surface can accurately predict the pathological nature of ECRC.
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