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Comparative effectiveness of i-SCAN^(TM) and high-definition white light characterizing small colonic polyps

World Journal of Gastroenterology 2012年第41期18卷 5905-5911页

作者： Johanna L Chan Li Lin michael feiler Andrew I Wolf Diana M Cardona Ziad F Gellad Department of Medicine Duke University Medical CenterDurham NC 27705 United States Duke Clinical Research Institute DurhamNC 27705 United States Department of Pathology Duke UniversityMedical Center Durham NC 27705 United States Durham VA Medical Center Durham NC 27705United States

AIM:To evaluate accuracy of in vivo diagnosis of adenomatous vs non-adenomatous polyps using i-SCAN digital chromoendoscopy compared with high-definition white ***:This is a single-center comparative effectiveness pilot ***(n = 103) from 75 averagerisk adult outpatients undergoing screening or surveillance colonoscopy between December 1,2010 and April 1,2011 were evaluated by two participating endoscopists in an academic outpatient endoscopy *** were evaluated both with high-definition white light and with i-SCAN to make an in vivo prediction of adenomatous vs non-adenomatous *** determined diagnostic characteristics of i-SCAN and highdefinition white light,including sensitivity,specificity,and accuracy,with regards to identifying adenomatous vs non-adenomatous *** diagnosis was the gold standard ***:One hundred and three small polyps,detected from forty-three patients,were included in the *** average size of the polyps evaluated in the analysis was 3.7 mm(SD 1.3 mm,range 2 mm to 8 mm).Formal histopathology revealed that 54/103(52.4%) were adenomas,26/103(25.2%) were hyperplastic,and 23/103(22.3%) were other diagnoses include "lymphoid aggregates","non-specific colitis," and "no pathologic diagnosis." Overall,the combined accuracy of endoscopists for predicting adenomas was identical between i-SCAN(71.8%,95%CI:62.1%-80.3%) and high-definition white light(71.8%,95%CI:62.1%-80.3%).However,the accuracy of each endoscopist differed substantially,where endoscopist A demonstrated 63.0% overall accuracy(95%CI:50.9%-74.0%) as compared with endoscopist B demonstrating 93.3% overall accuracy(95%CI:77.9%-99.2%),irrespective of imaging *** endoscopist demonstrated a significant learning effect with i-SCAN during the *** endoscopist A increased accuracy using i-SCAN from 59%(95%CI:42.1%-74.4%) in the first half to 67.6%(95%CI:49.5%-82.6%) in the second half,and endoscopist B de

关键词：数字高清晰度结肠镜白光病理组织学诊断肉效益特征平均风险

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