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使用白光和LCI的结肠息肉检测—系统评价和荟萃分析
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LCI文献
使用白光和LCI的结肠息肉检测—系统评价和荟萃分析
2022/03/11LCI文献
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使用白光和LCI的结肠息肉检测—系统评价和荟萃分析
Colon polyp detection using linked color imaging compared to white light imaging: Systematic review and meta-analysis
S Shinozaki, Y Kobayashi, Y Hayashi… - Digestive Endoscopy, 2020
与白光相比，LCI具有显著更高地息肉和腺瘤检出率以及先前漏诊的息肉检出率。我们建议进行常规结肠镜检查开始就使用LCI。
Conclusions: Linked color imaging has significantly greater polyp and adenoma detection rates and detection rate of previously missed polyps compared with WLI. We recommend the initial use of LCI for routine colonoscopy.
01
背景和研究目的
LCI是一种新的图像增强技术，增强结直肠病变和周围黏膜之前的色差，并具有足够的亮度来照亮结直肠管腔。本研究的目的是比较LCI组和白光组的结直肠息肉检出率。
Background and Aims: Linked color imaging (LCI) is a novel image-enhancing technology which enhances color differences between a colorectal lesion and surrounding mucosa with enough brightness to illuminate the wide colorectal lumen. The aim of this study is to compare colorectal polyp detection using LCI with that using white light imaging (WLI).
02
方法
对比LCI组和白光组在结直肠息肉检出中的随机对照实验和前瞻性研究。结果包括整体息肉/腺瘤检出和二次观察时发现的息肉。使用Mantel-Haenszel随机效应模型通过95%置信区间（CI）的汇总风险比（RR）记录结果。
Methods: Randomized controlled trials and prospective studies comparing LCI with WLI for colorectal polyp detection were selected. Outcomes included overall polyp/adenoma detection and additional polyp detection at a second observation. Outcomes were documented by pooled risk ratios (RR) with 95% confidence interval (CI) using the Mantel-Haenszel random effect model.
03
结果
包括了七项研究。与白光相比，LCI在息肉和腺瘤检测方面具有明显优势（息肉检测RR 1.16, 95% CI 1.09-1.25, P < 0.001; 腺瘤检测RR 1.26, 95% CI 1.14-1.39 P < 0.001）。与白光相比，LCI显著增加了每位患者检测到的息肉数量（平均差异0.27，95% CI 0.08-0.36, P = 0.002）。与白光相比，LCI显著增加了每位患者检测到的腺瘤数量（平均差异0.22，95% CI 0.08-0.36, P = 0.002）。与白光相比，LCI显著增加了每位患者检测到的扁平息肉数量（平均差异0.14，95% CI 0.01-0.27, P = 0.040）。LCI在右侧结肠二次观察发现的息肉检出率明显高于白光（RR 2.68, 95% CI 1.71-4.19, P < 0.001）。
Results: Seven studies were included. LCI showed significant superiority for polyp and adenoma detection compared with WLI (RR 1.16, 95% CI 1.09-1.25, P < 0.001 for polyp detection; RR 1.26, 95% CI 1.14-1.39 P < 0.001 for adenoma detection). LCI significantly increased the number of polyps detected per patient compared with WLI (mean difference 0.27, 95% CI 0.01-0.53, P = 0.040). LCI significantly increased the number of adenomas detected per patient compared with WLI (mean difference 0.22, 95% CI 0.08-0.36, P = 0.002). LCI significantly increased the number of flat polyps detected per patient compared with WLI (mean difference 0.14, 95% CI 0.01-0.27, P = 0.040). LCI had a significantly higher rate of additional polyp detection compared with WLI in the right colon (RR 2.68, 95% CI 1.71-4.19, P < 0.001).
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