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结肠胶囊内镜在检测家族性结直肠癌患者结直肠息肉中的准确性:我们能否避免结肠镜检查?

Accuracy of Colon Capsule Endoscopy in Detecting Colorectal Polyps in Individuals with Familial Colorectal Cancer: Could We Avoid Colonoscopies?

作者信息

Alvarez-Urturi Cristina, Fernández-Esparrach Gloria, Ibáñez Inés Ana, Rodríguez De Miguel Cristina, Dedeu Josep Maria, Bessa Xavier, Córdova Henry, Pellisé Maria, Balaguer Francesc, Ginés Angels, Barranco Luis, Araujo Isis K, Andreu Montserrat, Llach Josep, Castells Antoni, González-Suarez Begoña

机构信息

Department of Gastroenterology, Hospital del Mar, UAB, Parc de Salut Mar, Barcelona, Catalonia, Spain.

Gastroenterology Department, Endoscopy Unit, ICMDiM, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Catalonia, Spain.

出版信息

Gastroenterol Res Pract. 2017;2017:1507914. doi: 10.1155/2017/1507914. Epub 2017 Feb 7.

Abstract

. Individuals with a family history of colorectal cancer (CRC) have an increased risk of CRC. We evaluated the diagnostic yield of CCE in the detection of lesions and also two different colon preparations. . A prospective multicenter study was designed to assess CCE diagnostic yield in a cohort of asymptomatic individuals with a family history of CRC. CCE and colonoscopy were performed on the same day by 2 endoscopists who were blinded to the results of the other procedure. . Fifty-three participants were enrolled. The sensitivity, specificity, PPV, and NPV of CCE for detecting advanced adenomas were 100%, 98%, 67%, and 100%. Sensitivity, specificity, PPV, and NPV of CCE for the diagnosis of individuals with polyps were 87%, 97%, 93%, and 88%, respectively. CCE identify 100% of individuals with significant or advanced lesions. Overall cleanliness was adequate by 60.7% of them. The PEG-ascorbic boost seems to improve colon cleanliness, with similar colonic transit time. . CCE is a promising tool, but it has to be considered as an alternative technique in this population in order to reduce the number of colonoscopies performed. More studies are needed to understand appropriate screening follow-up intervals and optimize the bowel preparation regimen.

摘要

有结直肠癌(CRC)家族史的个体患CRC的风险增加。我们评估了胶囊内镜检查(CCE)在病变检测中的诊断率以及两种不同的结肠准备方法。 一项前瞻性多中心研究旨在评估CCE在一组有CRC家族史的无症状个体中的诊断率。CCE和结肠镜检查由两名对另一项检查结果不知情的内镜医师在同一天进行。 招募了53名参与者。CCE检测高级别腺瘤的敏感性、特异性、阳性预测值和阴性预测值分别为100%、98%、67%和100%。CCE诊断息肉患者的敏感性、特异性、阳性预测值和阴性预测值分别为87%、97%、93%和88%。CCE能识别100%有显著或高级别病变的个体。其中60.7%的患者结肠整体清洁度良好。聚乙二醇-维生素C增强方案似乎能改善结肠清洁度,且结肠转运时间相似。 CCE是一种有前景的工具,但在该人群中必须将其视为一种替代技术,以减少结肠镜检查的次数。需要更多研究来了解合适的筛查随访间隔并优化肠道准备方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d136/5318633/504ee549e6ce/GRP2017-1507914.001.jpg

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