title: Narrow-band imaging observation of colorectal lesions using NICE classification to avoid discarding significant lesions.
abstract: OBJECTIVE
  To assess the risk of failing to detect diminutive and small colorectal cancers with the "resect and discard" policy.
  
  
  METHODS
  Patients who received colonoscopy and polypectomy were recruited in the retrospective study. Probable histology of the polyps was predicted by six colonoscopists by the use of NICE classification. The incidence of diminutive and small colorectal cancers and their endoscopic features were assessed.
  
  
  RESULTS
  In total, we found 681 cases of diminutive (1-5 mm) lesions in 402 patients and 197 cases of small (6-9 mm) lesions in 151 patients. Based on pathology of the diminutive and small polyps, 105 and 18 were non-neoplastic polyps, 557 and 154 were low-grade adenomas, 18 and 24 were high-grade adenomas or intramucosal/submucosal (SM) scanty invasive carcinomas, 1 and 1 were SM-d carcinoma, respectively. The endoscopic features of invasive cancer were classified as NICE type 3 endoscopically.
  
  
  CONCLUSIONS
  The risk of failing to detect diminutive and small colorectal invasive cancer with the "resect and discard" strategy might be avoided through the use of narrow-band imaging observation with the NICE classification scheme and magnifying endoscopy.
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Santa
authors.initials: S
authors.lastname: Hattori
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Mineo
authors.initials: M
authors.lastname: Iwatate
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Sano
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hasuike
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kosaka
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Ikumoto
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Kotaka
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ichiyanagi
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisutani
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Hisano
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
authors.affiliation: Santa Hattori, Mineo Iwatate, Wataru Sano, Noriaki Hasuike, Hidekazu Kosaka, Taro Ikumoto, Masahito Kotaka, Akihiro Ichiyanagi, Yasushi Sano, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Sano Hospital, Hyogo 655-0031, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sano
keywords: Colonoscopy; Image-enhanced endoscopy; Magnifying endoscope; NICE classification; Narrow-band imaging; Resect and discard; SM-d