title: Kudo's pit pattern classification for colorectal neoplasms: a meta-analysis.
abstract: OBJECTIVE
  To analyze the current available evidence of Kudo's pit pattern classification for diagnosing colorectal neoplasms.
  
  
  METHODS
  A search was performed on Pubmed/Embase to identify studies reporting the outcomes of the pit pattern classification in colorectal polyps. Retrieved records were evaluated and selected by two independent investigators. The number of patients, polyps and diagnostic performance of Kudo's pit pattern classification were retrieved from suitable studies. Pooled sensitivities and specificities were calculated using fixed or random effect models according to their heterogeneity. Publication bias was evaluated using funnel plot, Egger's test, and Begg's test. Sensitivity analysis was performed by omitting one study at a time and selecting a subgroup consisting of 11 magnifying chromoendoscopy studies.
  
  
  RESULTS
  20 eligible studies were included in which a total of 5111 colorectal lesions in 3418 patients were identified for the differentiation of neoplastic and non-neoplastic polyps. Pit pattern classification in all the studies of mucosal patterns with magnification resulted in a pooled sensitivity of 89.0% (95%CI: 85.2-91.9) and pooled specificity of 85.7% (95%CI: 81.3-89.2) and the area under the SROC curve was 0.9354. There was significant publication bias (P = 0.038 and 0.006 for sensitivity and specificity using Egger's test, P = 0.035 and 0.139 for sensitivity and specificity using Begg's test, respectively). No single study significantly affected the pooled result, and the magnifying chromoendoscopy subgroup yielded a sensitivity of 92.7% (95%CI: 89.2-95.2) and specificity of 87.3% (95%CI: 81.6-91.4).
  
  
  CONCLUSIONS
  Kudo's pit pattern classification is an accurate diagnostic method for the differentiation of neoplastic colorectal lesions. Publication bias is significant in the current available literature.
authors.affiliation: Ming Li, Syed Mohsin Ali, Syeda Umm-a-OmarahGilani, Jing Liu, Yan-Qing Li, Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Ming Li, Syed Mohsin Ali, Syeda Umm-a-OmarahGilani, Jing Liu, Yan-Qing Li, Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Syed Mohsin
authors.initials: SM
authors.lastname: Ali
authors.affiliation: Ming Li, Syed Mohsin Ali, Syeda Umm-a-OmarahGilani, Jing Liu, Yan-Qing Li, Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Syeda
authors.initials: S
authors.lastname: Umm-a-OmarahGilani
authors.affiliation: Ming Li, Syed Mohsin Ali, Syeda Umm-a-OmarahGilani, Jing Liu, Yan-Qing Li, Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Ming Li, Syed Mohsin Ali, Syeda Umm-a-OmarahGilani, Jing Liu, Yan-Qing Li, Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Yan-Qing
authors.initials: YQ
authors.lastname: Li
authors.affiliation: Ming Li, Syed Mohsin Ali, Syeda Umm-a-OmarahGilani, Jing Liu, Yan-Qing Li, Xiu-Li Zuo, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Xiu-Li
authors.initials: XL
authors.lastname: Zuo
mesh_terms: D019540:Area Under Curve; D016009:Chi-Square Distribution; D003111:Colonic Polyps / Q000145:classification / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000145:classification / Q000473:pathology*; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D006801:Humans; D007089:Image Enhancement; D011237:Predictive Value of Tests; D012372:ROC Curve
keywords: Colonic neoplasia; Endoscope; Magnifying endoscopy; Meta-analysis; Sensitivity; Specificity