Department of Gastroenterology, West China Hospital of Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, Sichuan Province, China.
J Gastroenterol. 2018 Jun;53(6):701-711. doi: 10.1007/s00535-018-1436-4. Epub 2018 Jan 30.
Colorectal polyps are commonly seen in colonoscopy and the management of neoplastic polyps and non-neoplastic polyps are different. It is necessary to distinguish neoplastic polyps from non-neoplastic polyps in real-time. Therefore, we conducted a meta-analysis to assess the diagnostic accuracy of magnifying endoscopy with narrow-band imaging (ME-NBI) in diagnosing neoplastic colorectal polyps from non-neoplastic colorectal polyps. PubMed and EMBASE were searched for trials that used magnifying endoscopy with ME-NBI for diagnosing neoplastic colorectal polyps. Sixteen articles and 20 fourfold tables were obtained. Sensitivity (Sen), specificity (Spe), positive likelihood ratios (+ LRs), negative likelihood ratios (- LRs) and diagnostic odds ratios (DORs) were calculated. A summary receiver-operating characteristic (SROC) curve was constructed, and the area under the ROC curve (AUC) was calculated. We performed subgroup analyses based on polyp size and assessment criteria: (1) According to data extracted from 20 fourfold tables, the pooled Sen and Spe of ME-NBI for diagnosing neoplastic colorectal polyps < 10 mm were 0.94 (95% CI 0.92-0.95) and 0.76 (95% CI 0.72-0.80),respectively. The pooled Sen and Spe of ME-NBI for diagnosing all neoplastic polyps were 0.98 (95% CI 0.98-0.99) and 0.88 (95% CI 0.85-0.90), respectively. (2) Data pertaining to the following three assessment methods were analysed from 15 fourfold tables: surface pattern (SP), vessel pattern (VP) and the combination of SP and VP. The AUCs for these assessment criteria were 0.9533, 0.9518 and 0.9954, respectively. Conclusions were made that ME-NBI has high diagnostic accuracy in diagnosing neoplastic colorectal polyps based on the combination of SP with VP and is helpful in making real-time diagnoses.
结直肠息肉在结肠镜检查中很常见，对肿瘤性息肉和非肿瘤性息肉的处理是不同的。因此，需要实时区分肿瘤性息肉和非肿瘤性息肉。因此，我们进行了一项荟萃分析，以评估窄带成像放大内镜（ME-NBI）在诊断结直肠肿瘤性息肉和非肿瘤性息肉中的诊断准确性。在 PubMed 和 EMBASE 上搜索了使用 ME-NBI 诊断结直肠肿瘤性息肉的试验。获得了 16 篇文章和 20 个四格表。计算了敏感性（Sen）、特异性（Spe）、阳性似然比（+LRs）、阴性似然比（-LRs）和诊断比值比（DORs）。绘制了汇总受试者工作特征（SROC）曲线，并计算了 ROC 曲线下面积（AUC）。我们根据息肉大小和评估标准进行了亚组分析：（1）根据 20 个四格表中提取的数据，ME-NBI 诊断<10mm 结直肠肿瘤性息肉的汇总 Sen 和 Spe 分别为 0.94（95%CI 0.92-0.95）和 0.76（95%CI 0.72-0.80）。ME-NBI 诊断所有肿瘤性息肉的汇总 Sen 和 Spe 分别为 0.98（95%CI 0.98-0.99）和 0.88（95%CI 0.85-0.90）。（2）从 15 个四格表中分析了以下三种评估方法的数据：表面模式（SP）、血管模式（VP）和 SP 与 VP 的组合。这些评估标准的 AUC 分别为 0.9533、0.9518 和 0.9954。结果表明，基于 SP 与 VP 的组合，ME-NBI 对诊断结直肠肿瘤性息肉具有较高的诊断准确性，有助于实时诊断。
