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高清结肠镜检查比标准白光结肠镜检查检测结直肠息肉的检出率更高。

High-definition colonoscopy detects colorectal polyps at a higher rate than standard white-light colonoscopy.

机构信息

Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida 32224, USA.

出版信息

Clin Gastroenterol Hepatol. 2010 Apr;8(4):364-70. doi: 10.1016/j.cgh.2009.11.009. Epub 2009 Nov 22.

Abstract

BACKGROUND & AIMS: Adenoma detection rates might be improved through use of high-definition colonoscopy, which can detect subtle mucosal changes. We investigated whether the use of high-definition white-light (HDWL) colonoscopy resulted in a higher rate of adenoma detection than standard-definition white-light (SDWL) colonoscopy in a clinical practice setting.

METHODS

This retrospective study included 2430 patients who underwent colonoscopies from September 2006 to December 2007; 1226 received SDWL colonoscopy and 1204 received HDWL colonoscopy. We analyzed data from consecutive screening, surveillance, and diagnostic colonoscopies, comparing adenoma and overall polyp detection between procedures. Potentially confounding variables were controlled using multivariable logistic regression analysis.

RESULTS

The adenoma detection rate was higher among patients who underwent HDWL compared with SDWL colonoscopies (28.8% vs 24.3%; P = .012), as was the polyp detection rate (42.2% vs 37.8%; P = .026). These findings remained after adjustments for potentially confounding variables (P = .018 and .022, respectively).

CONCLUSIONS

In a general clinical practice setting, HDWL colonoscopy resulted in a higher adenoma detection rate compared with SDWL colonoscopy. The use of SDWL colonoscopy could reduce the number of missed adenomas and the subsequent risk for colorectal cancer.

摘要

背景与目的

高清结肠镜检查可以检测到细微的黏膜变化,从而提高腺瘤检出率。我们研究了在临床实践环境中,与标准白光结肠镜相比,高清白光(HDWL)结肠镜是否能提高腺瘤检出率。

方法

这项回顾性研究纳入了 2430 例于 2006 年 9 月至 2007 年 12 月接受结肠镜检查的患者;其中 1226 例行标准白光结肠镜检查,1204 例行高清白光结肠镜检查。我们分析了连续筛查、监测和诊断性结肠镜检查的数据,比较了两种检查方法中腺瘤和总体息肉的检出率。使用多变量逻辑回归分析控制潜在混杂变量。

结果

与行标准白光结肠镜相比,行高清白光结肠镜的患者腺瘤检出率更高(28.8%比 24.3%;P=0.012),息肉检出率也更高(42.2%比 37.8%;P=0.026)。在调整了潜在混杂变量后,这些发现仍然存在(分别为 P=0.018 和 P=0.022)。

结论

在一般临床实践环境中,高清白光结肠镜检查与标准白光结肠镜相比,能提高腺瘤检出率。使用标准白光结肠镜检查可以减少漏诊腺瘤的数量,进而降低结直肠癌的风险。

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