Efficacy of image-enhanced endoscopy for colorectal adenoma detection:A multicenter,randomized trial

作     者：Zhi-Peng Qi En-Pan Xu Dong-Li He Yan Wang Bai-Sheng Chen Xue-Si Dong Qiang Shi Shi-Lun Cai Qi Guo Ni Li Xing Li Hai-Yan Huang Bing Li Di Sun Jian-Guang Xu Zhang-Han Chen Ayimukedisi Yalikong Jin-Yi Liu Zhen-Tao Lv Jian-Min Xu Ping-Hong Zhou Yun-Shi Zhong 

作者机构：Endoscopy CenterZhongshan Hospital of Fudan UniversityShanghai 200030China Endoscopy CenterShanghai Xuhui Central HospitalShanghai 200030China Endoscopy CenterTraditional Chinese Medical HospitalRongcheng 264300Shandong ProvinceChina Department of Endoscopy CenterXiamen Branch of Affiliated Zhongshan Hospital of Fudan UniversityXiamen 361000Fujian ProvinceChina Office of Cancer ScreeningNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100000China Department of GastroenterologyPingxiang People’s HospitalPingxiang 337000Jiangxi ProvinceChina Department of Clinical MedicineXiaogang HospitalNingbo 315000Zhejiang ProvinceChina Endoscopy CenterQuzhou People’s HospitalQuzhou 324000Zhejiang ProvinceChina Department of General SurgeryZhongshan Hospital of Fudan UniversityShanghai 200030China 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志（英文版）（电子版）)

年 卷 期：2023年第15卷第5期

页      面：878-891页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by the National Key R&D Program of China,No. 2018YFC1315005 National Natural Science Foundation of China,No. 82002515 Shanghai Sailing Program,No. 20YF1407200 China Postdoctoral Science Foundation,No. 2020M681177 

主　　题：Endoscopy Image-enhanced endoscopy Adenoma detection rate White-light imaging Narrowband imaging 

摘      要：BACKGROUND Improved adenoma detection at colonoscopy has decreased the risk of developing colorectal ***,whether image-enhanced endoscopy(IEE)further improves the adenoma detection rate(ADR)is *** To compare IEE with white-light imaging(WLI)endoscopy for the detection and identification of colorectal *** This was a multicenter,randomized,controlled *** were enrolled between September 2019 to April 2021 from 4 hospital in *** were randomly assigned to an IEE group with WLI on entry and IEE on withdrawal(n=2113)or a WLI group with WLI on both entry and withdrawal(n=2098).The primary outcome was the *** secondary endpoints were the polyp detection rate(PDR),adenomas per colonoscopy,adenomas per positive colonoscopy,and factors related to adenoma *** A total of 4211 patients(966 adenomas)were included in the analysis(mean age,56.7 years,47.1%male).There were 2113 patients(508 adenomas)in the IEE group and 2098 patients(458 adenomas)in the WLI *** ADR in two group were not significantly different[24.0%vs 21.8%,1.10,95%confidence interval(CI):0.99-1.23,P=0.09].The PDR was higher with IEE group(41.7%)than with WLI group(36.1%,1.16,95%CI:1.07-1.25,P=0.01).Differences in mean withdrawal time(7.90±3.42 min vs 7.85±3.47 min,P=0.30)and adenomas per colonoscopy(0.33±0.68 vs 0.28±0.62,P=0.06)were not *** analysis found that with narrowband imaging(NBI),between-group differences in the ADR,were not significant(23.7%vs 21.8%,1.09,95%CI:0.97-1.22,P=0.15),but were greater with linked color imaging(30.9%vs 21.8%,1.42,95%CI:1.04-1.93,P=0.04).the second-generation NBI(2G-NBI)had an advantage of ADR than both WLI and the first-generation NBI(27.0%vs 21.8%,P=0.01;27.0%vs 21.2.0%,P=0.01).CONCLUSION This prospective study confirmed that,among Chinese,IEE didn’t increase the ADR compared with WLI,but 2G-NBI increase the ADR.