Wong Robert F, Tuteja Ashok K, Haslem Derrick S, Pappas Lisa, Szabo Aniko, Ogara Maydeen M, DiSario James A
Department of Internal Medicine, Division of Gastroenterology, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
Gastrointest Endosc. 2006 Oct;64(4):530-7. doi: 10.1016/j.gie.2005.12.014.
Video capsule endoscopy (VCE) may be useful for surveillance of small-bowel polyps in patients with familial adenomatous polyposis (FAP).
To compare VCE to standard endoscopy for diagnosing small-bowel polyps in a defined segment of small bowel (proximal to a tattoo) and the entire examined small bowel.
Prospective.
Single tertiary referral center.
Participants with FAP (n = 32). The majority were selected for their high number of proximal small-bowel polyps and prior endoscopic tattoo placement in the proximal small bowel.
VCE (interpreted by 2 readers), push enteroscopy (PE), and lower endoscopy (LE) to count and measure small-bowel polyps.
In the defined segment, VCE detected a median of 10.0 (interquartile range [IQR], 5.0-19.0) and 9.0 (IQR, 6.0-16.0) polyps for each reader compared with a median of 41.0 (IQR, 19.0-64.0) polyps on PE (P = .002). Agreement between the 2 methods was fair (kappa = 0.34, 0.36). Agreement between VCE and PE was poor to fair (kappa = 0.10, 0.22) for estimating the size of the largest polyp and poor (kappa = -0.20, -0.27) for detecting large polyps (> or =1 cm). In the entire examined small bowel, VCE diagnosed a median of 38.0 (IQR, 10.5-71.5) and 54.0 (IQR, 13.0-100.0) polyps for each reader compared with a median of 123.0 (IQR, 38.5-183.0) for combination endoscopy (PE and LE) (P < .001). Agreement between the 2 methods was fair to moderate (kappa = 0.21, 0.56).
Participants selected for high polyp burden, and results may not be applicable to all patients with FAP.
VCE underestimates the number of small-bowel polyps in persons with FAP and does not reliably detect large polyps.
视频胶囊内镜检查（VCE）可能有助于对家族性腺瘤性息肉病（FAP）患者的小肠息肉进行监测。
比较VCE与标准内镜检查在诊断小肠特定节段（纹身近端）及整个检查小肠中的小肠息肉情况。
前瞻性研究。
单一的三级转诊中心。
FAP参与者（n = 32）。大多数患者因近端小肠息肉数量多且之前在近端小肠进行过内镜纹身定位而入选。
VCE（由2名阅片者解读）、推进式小肠镜检查（PE）和低位内镜检查（LE），以计数和测量小肠息肉。
在特定节段，每位阅片者通过VCE检测到的息肉中位数分别为10.0（四分位间距[IQR]，5.0 - 19.0）和9.0（IQR，6.0 - 16.0），而PE检测到的息肉中位数为41.0（IQR，19.0 - 64.0）（P = 0.002）。两种方法之间的一致性为中等（kappa = 0.34，0.36）。对于估计最大息肉的大小，VCE与PE之间的一致性为差到中等（kappa = 0.10，0.22），对于检测大息肉（≥1 cm）一致性较差（kappa = -0.20，-0.27）。在整个检查的小肠中，每位阅片者通过VCE诊断出的息肉中位数分别为38.0（IQR，10.5 - 71.5）和54.0（IQR，13.0 - 100.0），而联合内镜检查（PE和LE）诊断出的息肉中位数为123.0（IQR，38.5 - 183.0）（P < 0.001）。两种方法之间的一致性为中等至良好（kappa = 0.21，0.56）。
入选的参与者息肉负担重，结果可能不适用于所有FAP患者。
VCE低估了FAP患者小肠息肉的数量，且不能可靠地检测到大息肉。
