Dijagnostička točnost NICE klasifikacijskog sustava optičkog prepoznavanja prediktivne morfologije kolorektalnih polipa

master's thesis

• Title (english): Diagnostic Accuracy of NICE Classification System for Optical Recognition of Predictive Morphology of Colorectal Polyps
• Author: Josipa Patrun
• Mentor: Nadan Rustemović (mentor)
• Committee member: Rajko Ostojić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Nadan Rustemović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

NICE klasifikacija (Narrow-band imaging International Colorectal Endoscopic Classification) je međunarodna endoskopska klasifikacija kolorektalnih novotvorina uskopojasnim spektrom koja na osnovu boje lezije, krvožilnog uzorka i građe površine
sluznice klasificira kolorektalne novotvorine u tri kategorije: tip 1 su hiperplastične lezije, tip 2 adenomi i tip 3 invazivni karcinomi. Cilj ovog istraživanja bio je provjeriti dijagnostičku točnost NICE klasifikacijskog sustava u odnosu na referentni standard: patohistološku analizu. Ovo retrospektivno istraživanje provedeno je u razdoblju od srpnja 2015. do srpnja 2016. godine na Zavodu za gastroenterologiju i hepatologiju Klinike za unutarnje bolesti KBC-a Zagreb na susljednom uzorku od 418 bolesnika i 735 polipa, a preglede je obavljalo deset liječnika KBC-a Zagreb. Ukupna dijagnostička točnost NICE klasifikacijskog sustava
iznosila je 76.7%. Optičko prepoznavanje značajno je bolje kod većih polipa, lezija visokog rizika (HGIEN) i neoplastičnih lezija. Ovo istraživanje je pokazalo da je NICE klasifikacijski sustav za sada inferioran patohistološkoj analizi. Međutim, vidljivo je kako neki liječnici ostvaruju značajno bolje rezultate, uz točnost dijagnoze u rasponu od 59.5% do 84.2%. Ovakvi rezultati pokazuju da bi uz valjanu edukaciju i doedukaciju liječnika te uz korištenje dodataka endoskopima za poboljšanje kvalitete slike, NICE klasifikacijski sustav kolorektalnih polipa u budućnosti potencijalno mogao zamijeniti proces patohistološke dijagnostike.

Abstract (english)

The NICE classification is an international endoscopic classification of colorectal neoplasia through a narrowband spectrum that on the basis of lesion color, vascular pattern, and structure of the surface of the mucous membrane classifies colorectal neoplasms in to three categories: type 1 as hyperplastic lesions, type 2 as adenomas, and type 3 as invasive tumors. The aim of this study was to verify the diagnostic accuracy of the NICE classification system compared to the reference standard: histopathological analysis. This retrospective study was conducted by ten physicians on a sequential sample of 418 patients and 735 polyps. The total diagnostic accuracy of the NICE classification system was found to be 76.7%. Optical recognition was significantly better with larger polyps, high-risk lesions (HGIEN) and neoplastic lesions. This research has shown that the NICE classification system is at the moment inferior to histopathological analysis. However, it is noticed that some physicians achieve significantly better results, with the accuracy of diagnosis ranging from 59.5% to 84.2%. These results show that with proper training of physicians and the use of endoscopic enhancements to improve image quality, the NICE classification system could in the future potentially replace the histopathological diagnosis process.

• Keywords: kolorektalni polip; NICE klasifikacija; patohistologija; NBI; kolonoskopija
• Keywords (english): colorectal polyp; NICE classification; pathohistology; NBI; colonoscopy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:668451
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-19 12:04:16