Effect of the 304 retrospective analysis training method for enhancing the diagnostic accuracy of endoscopists in iden-tifying gastrointestinal submucosal tumors

Li Chenyang; Li Xueqin; Zhang Ningning; Xu Zhongrui; Wang Tao; Huang Fuxiu; Liu Guipeng; Liu Yuying; Chen Chao

doi:10.3969/j.issn.1672-8521.2025.04.014

Abstract：Objective:To investigate the efficacy of the 304 retrospective analysis training method in enhancing the diagnostic accuracy of endoscopists for gastrointestinal submucosal tumors.Methods:Ten endoscopists from the Department of Gastroenterology of the Fourth Medical Center of the PLA General Hospital were selected.All the physicians had relatively rich endoscopic operation experience and had participated in the basic training of endoscopic ultrasound.They were randomly divided into a training group(n=5)and a control group(n=5)by the random number table method.The training group received"white light-ultrasound-pathology"retrospective training utilizing the 304 retrospective analysis training method.Another 92 patients underwent endoscopic ultrasound examination from January 2019 to January 2024 were selected and randomly allocated to the training group(n=47)and the control group(n=45).Endoscopists in the training group and the control group conducted the examinations respectively,with the pathological diagnosis results as the gold standard.The diagnostic accuracy of submucosal tumors of the digestive tract was analyze in the control group and the training group.Results:A total of 92 patients with gastrointestinal submucosal tumors were included in this study.The common locations of the lesions were the gastric body(n=19),gastric antrum(n=18),and rectum(n=16),and the prevalent lesion types included leiomyoma(n=22),gastrointestinal stromal tumor(GIST)(n=21),and neuroendocrine tumor(n=14).Both white-light endoscopy and endoscopic ultrasonography demonstrated high accuracy in assessing lesion size.Endoscopic ultrasound achieved an accuracy of 65.2%(60/92)in evaluating the layer of origin of the lesions.The training group showed an accuracy of 68.1%(32/47),which was higher than the control group's 62.2%(28/45),but the difference was not statistically significant(χ²=0.348,P＞0.05).As the diagnostic accuracy of endoscopists in the training group for determining the layer of origin of lesions improved year by year,the proportion of patients opting for endoscopic surgery also increased annually.Through the"304 retrospective analy-sis training",endoscopists significantly enhanced their diagnostic accuracy in determining the nature of lesions under endoscopic ultrasound.The accuracy of training group achieved 83.0%(39/47),which was significantly higher than that of the control group(57.8%,26/45),and the difference was statistically significant(χ²=7.041,P＜0.01).Conclusions:The 304 retrospective analysis training method significantly improves the diagnostic accuracy of endoscopists in identifying the patho-logical characteristics of gastrointestinal submucosal tumors and enhances the precision of lesion depth assessment,advocat-ing for its broader adoption,which is worthy of promotion.