Development and validation of an online calculator to predict the pathological nature of colorectal tumors

Ya-Dan Wang; Jing Wu; Bo-Yang Huang; Chun-Mei Guo; Cang-Hai Wang; Hui Su; Hong Liu; Miao-Miao Wang; Jing Wang; Li Li; Peng-Peng Ding; Ming-Ming Meng

doi:10.4251/wjgo.v15.i7.1271

Development and validation of an online calculator to predict the pathological nature of colorectal tumors

World J Gastrointest Oncol. 2023 Jul 15;15(7):1271-1282. doi: 10.4251/wjgo.v15.i7.1271.

Authors

Ya-Dan Wang¹, Jing Wu², Bo-Yang Huang³, Chun-Mei Guo¹, Cang-Hai Wang¹, Hui Su¹, Hong Liu¹, Miao-Miao Wang¹, Jing Wang⁴, Li Li¹, Peng-Peng Ding¹, Ming-Ming Meng¹

Affiliations

¹ Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
² Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing 100050, China.
³ Department of Gastroenterology, Beijing Shijitan Hospital, the Ninth Clinical Medicine Peking University, Beijing 100038, China.
⁴ Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China. wujing36youyi@ccmu.edu.cn.

Abstract

Background: No single endoscopic feature can reliably predict the pathological nature of colorectal tumors (CRTs).

Aim: To establish and validate a simple online calculator to predict the pathological nature of CRTs based on white-light endoscopy.

Methods: This was a single-center study. During the 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 images was established and verified internally. During the validation stage, two series of 110 images obtained using white-light endoscopy were distributed to 10 endoscopists [five highly experienced endoscopists 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 years. Early colorectal cancer (ECRC) was detected in 351 (46.8%) patients. Tumor size, left semicolon site, rectal site, acanthosis, depression and an uneven surface were independent risk factors for ECRC. The C-index of the ECRC calculator prediction model was 0.906 (P = 0.225, Hosmer-Lemeshow test). For the LEEs, significant improvement was made in the sensitivity, specificity and accuracy (57.6% vs 75.5%; 72.3% vs 82.4%; 64.2% vs 80.2%; P < 0.05), respectively, after training with the 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.

Keywords: Colorectal tumors; Early colorectal cancer; Online calculator; Pathological nature; White-light endoscopy.