AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Gastrointest Endosc. 2012 Mar;75(3):604-11. doi: 10.1016/j.gie.2011.10.017.
At colonoscopy, missed adenomas have been well documented at approximately 22%. The challenge is in reducing this miss rate. Narrow-band imaging (NBI) has been extensively evaluated in prospective, randomized, controlled studies for polyp detection. Sample-size calculations show us that these studies may be underpowered, and hence a meta-analysis is required.
Our aim was to determine whether use of NBI enhances the detection of adenomas.
Meta-analyses were conducted of 7 studies using NBI for adenoma detection rate. MEDLINE, Embase, PubMed, and Cochrane databases were searched by using a combination of the following terms: "colonoscopy," "NBI," and "electronic chromoendoscopy."
There was a total of 2936 patients in the NBI studies.
Prospective, randomized trials of NBI versus standard white-light colonoscopy (WLC) were conducted. We excluded spray chromoendoscopy studies and studies of inflammatory bowel disease and polyposis syndromes.
Adenoma and polyp detection rates and the number of polyps and adenomas detected per person.
There was no statistically significant difference in the overall adenoma detection rate with the use of NBI or WLC (36% vs 34%; P = .413 [relative risk 1.06; 95% CI, 0.97-1.16]), and there was no statistically significant difference in polyp detection rate by using NBI or WLC (37% vs 35%; P = .289 [relative risk 1.22; 95% CI, 0.85-1.76]). When the number of adenomas and polyps per patient was analyzed, no significant difference was found between NBI and WLC (0.645 vs 0.59; P = .105 and 0.373 vs 0.348; P = .139 [weighted mean difference 0.19; 95% CI, ∞0.06 to 0.44], respectively).
Variability in NBI studies can reduce the accuracy of this analysis.
NBI did not increase adenoma or polyp detection rates.
在结肠镜检查中，约有 22%的患者存在漏诊腺瘤的情况。目前的挑战是降低这种漏诊率。窄带成像（NBI）已在多项前瞻性、随机、对照研究中广泛评估用于息肉检测。通过样本量计算可知，这些研究可能存在效力不足的情况，因此需要进行荟萃分析。
我们旨在确定 NBI 是否能提高腺瘤的检出率。
对使用 NBI 检测腺瘤的 7 项研究进行荟萃分析。通过以下组合术语检索 MEDLINE、Embase、PubMed 和 Cochrane 数据库：“colonoscopy”、“NBI”和“electronic chromoendoscopy”。
共有 2936 例患者在 NBI 研究中接受了检查。
进行前瞻性、随机试验，比较 NBI 与标准白光结肠镜检查（WLC）的效果。我们排除了喷洒染色内镜检查的研究以及炎症性肠病和息肉病综合征的研究。
腺瘤和息肉的检出率以及每人检出的息肉和腺瘤数量。
使用 NBI 或 WLC 时，腺瘤的总体检出率无统计学差异（36%比 34%；P=.413 [相对风险 1.06；95%CI，0.97-1.16]），使用 NBI 或 WLC 时，息肉的检出率也无统计学差异（37%比 35%；P=.289 [相对风险 1.22；95%CI，0.85-1.76]）。分析每位患者的腺瘤和息肉数量时，NBI 与 WLC 之间也未发现显著差异（0.645 比 0.59；P=.105 和 0.373 比 0.348；P=.139 [加权均数差值 0.19；95%CI，0.06 至 0.44]）。
NBI 研究的变异性可能降低了该分析的准确性。
NBI 并未提高腺瘤或息肉的检出率。
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