Endoscopic ultrasonography-related diagnostic accuracy and clinical significance on small rectal neuroendocrine neoplasms

doi:10.3748/wjg.v30.i7.774

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World Journal of Gastroenterology

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World J Gastroenterol. Feb 21, 2024; 30(7): 774-778
Published online Feb 21, 2024. doi: 10.3748/wjg.v30.i7.774

Endoscopic ultrasonography-related diagnostic accuracy and clinical significance on small rectal neuroendocrine neoplasms

Jun Weng, Yu-Fan Chen, Shu-Han Li, Yan-Hua Lv, Ruo-Bing Chen, Guo-Liang Xu, Shi-Yong Lin, Kun-Hao Bai

Jun Weng, Yu-Fan Chen, Guo-Liang Xu, Shi-Yong Lin, Kun-Hao Bai, Department of Endoscopy, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Jun Weng, Yu-Fan Chen, Guo-Liang Xu, Shi-Yong Lin, Kun-Hao Bai, State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong Province, China

Jun Weng, Yu-Fan Chen, Guo-Liang Xu, Shi-Yong Lin, Kun-Hao Bai, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, Guangdong Province, China

Shu-Han Li, Department of Management, Clinical Medical College of Tianjin Medical University, Tianjin 300000, China

Yan-Hua Lv, Ruo-Bing Chen, Cancer Prevention Center, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China

Co-first authors: Jun Weng and Yu-Fan Chen.

Co-corresponding authors: Kun-Hao Bai and Shi-Yong Lin.

Author contributions: Bai KH, Lin SY, Xu GL designed the research; Li SH, Lv YH and Chen RB collected the data; Weng J, Chen YF, Li SH did the analysis; Weng J, Chen YF, Bai KH and Lin SY prepared the manuscript draft; Bai KH and Li SH provided research support and revised the manuscript. All authors read and approved the final manuscript. Weng J and Chen YF contributed equally to this work as co-first authors. Bai KH and Lin SY contributed equally to this work as co-corresponding authors. The reasons are as follows. First, the research was performed as a collaborative effort, and the designation of co-first authors and co-corresponding authors authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. Second, Weng J and Chen YF contributed efforts of equal substance for the data analysis and preparing manuscript draft. Bai KH and Lin SY contributed efforts of equal substance for designing the research, preparing manuscript draft, providing research support and revising the manuscript. In summary, we believe that both designating Weng J and Chen YF as co-first authors and designating Bai KH and Lin SY as co-corresponding authors are fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.

Supported by Basic and Applied Basic Research Foundation of Guangzhou, No. 202201011331; National Natural Science Foundation of China, No. 82373118; and Natural Science Foundation of Guangdong Province, No.2023A1515010828.

Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.

Corresponding author: Kun-Hao Bai, MD, MPH, Attending Doctor, Department of Endoscopy, Sun Yat-Sen University Cancer Center, No. 651 Dongfengdong Street, Yuexiu District, Guangzhou 510060, Guangdong Province, China. baikh@sysucc.org.cn

Received: November 21, 2023
Peer-review started: November 21, 2023
First decision: December 12, 2023
Revised: December 19, 2023
Accepted: January 24, 2024
Article in press: January 24, 2024
Published online: February 21, 2024
Processing time: 91 Days and 21.6 Hours

Abstract

This research aimed to examine the diagnostic accuracy and clinical significance of endoscopic ultrasonography (EUS) in the context of small rectal neuroendocrine neoplasms (NENs). A total of 108 patients with rectal subepithelial lesions (SELs) with a diameter of < 20 mm were included in the analysis. The diagnosis and depth assessment of EUS was compared to the histology findings. The prevalence of NENs in rectal SELs was 78.7% (85/108). The sensitivity of EUS in detecting rectal NENs was 98.9% (84/85), while the specificity was 52.2% (12/23). Overall, the diagnostic accuracy of EUS in identifying rectal NENs was 88.9% (96/108). The overall accuracy rate for EUS in assessing the depth of invasion in rectal NENs was 92.9% (78/84). Therefore, EUS demonstrates reasonable diagnostic accuracy in detecting small rectal NENs, with good sensitivity but inferior specificity. EUS may also assist physicians in assessing the depth of invasion in small rectal NENs before endoscopic excision.

Keywords: Rectal neuroendocrine neoplasms; Endoscopic ultrasonography; Diagnosis; Depth of invasion

Core Tip: The diagnostic efficacy and clinical significance of endoscopic ultrasonography (EUS) on rectal neuroendocrine neoplasms (NENs) have not been well demonstrated owing to the infrequency of these particular disorders. In this manuscript, we compared the results of EUS with histology findings among a total of 108 patients with rectal subepithelial lesions with a diameter of < 20 mm. We found that EUS demonstrates reasonable diagnostic accuracy in detecting small rectal NENs, with good sensitivity but inferior specificity. EUS may also assist physicians in assessing the depth of invasion in small rectal NENs before endoscopic excision.