方法

我们在中国3家医院进行了一项多中心、交叉、前瞻性、随机对照实验。将患者随机分配至两组中的一组：（1）LCI-WLI 组：先行 LCI 检查然后采用 WLI 内镜进行第二次检查；或 （2）WLI-LCI 组。所有患者随机使用 LCI 和 WLI 交叉进行结肠镜检查。在第二次内镜检查中，切除所有病灶。主要评价指标是 LCI 和 WLI 内镜检出结直肠息肉的敏感性。次要评价指标是两组中每个患者的腺瘤检出率和息肉漏诊率相关因素分析。

Methods: We performed a multicenter, crossover, prospective, randomized controlled trial in 3 hospitals in China. All patients underwent crossover colonoscopies with LCI and WL endoscopy in a randomized order. All lesions were removed during the second endoscopic procedure. The primary outcome measure was the difference in sensitivity between LCI and WL endoscopy for the detection of colorectal polyps. The secondary outcome measures were the adenoma detection rate per patient in the 2 groups and the factors associated with polyp miss rates.

结果

共随机抽取152例患者，其中141例纳入分析。 LCI结肠镜检查的整体息肉检出率显著提高24%，与白光内镜检查相比，LCI检查的敏感性更高(91% vs 73%，P < .0001)。 此外，LCI诊断出更多的患者(32%)有息肉。 LCI的每个患者腺瘤检出率显著高于白光内镜(37% vs 28%; 95%可信区间为2.39%-19.41%)。  

Results: A total of 152 patients were randomized, and 141 were included in the analysis. The overall polyp detection rate increased significantly by 24% for LCI colonoscopy, corresponding to a higher sensitivity with LCI than with WL endoscopy (91% vs 73%, P < .0001). Furthermore, LCI identified significantly more patients (32%) with polyps. The per-patient adenoma detection rate was significantly higher for LCI than for WL endoscopy (37% vs 28%; 95% confidence interval, 2.39%-19.41%).