Endoscopic differential criteria for various types of polyps in patients with juvenile polyposis syndrome

AIM: to clarify endoscopic features that differentiates juvenile polyps from other types of polyps in patients with juvenile polyposis syndrome.

PAIENTS AND METHODS: the retrospective cohort study included 30 patients who met the clinical criteria for juvenile polyposis syndrome in Jan 2012 — Dec 2024. A total of 1026 colorectal neoplasms were analysed comparing endoscopic and morphological images. Endoscopic features that have a significant impact on the determination of juvenile polyps were assessed. The following factors were estimated: size, site, Paris classification criteria, polyp surface, discrepancy with the adenomatous pattern, presence of whitish pits.

RESULTS: the most important features are smooth surface, distinguished from adenomatous polyps include discrepancy with the adenomatous surface pattern according to the classifications of Kudo-Sano, as well as the presence of whitish pits of a round, irregular or elongated shape (p < 0.001). These criteria allow to determine with a probability of up to 80% that the detected neoplasm will be a juvenile polyp. The endoscopic diagnostic method has a high sensitivity of 93.9% (95% CI: 89.1–97.0) and a negative predictive value of 90.7% (95% CI: 83.5–95.4) in detecting juvenile polyps.

CONCLUSION: endoscopic features of juvenile polyps (smooth surface, the discrepancy with the adenomatous surface pattern according to the classifications of Kudo S. and Sano Y., as well as the presence of whitish pits of a round, irregular or elongated shape) were identified.

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