Romańczyk Marcin, Romańczyk Tomasz, Bołdys Hubert, Koziej Mateusz, Jarus Krzysztof
H-T. Centrum Medyczne-Endoterapia, Tychy, Poland.
Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
Prz Gastroenterol. 2018;13(3):206-212. doi: 10.5114/pg.2018.78286. Epub 2018 Sep 17.
The detection of adenomas is the basic goal for colorectal cancer screening programs; therefore, every possibility to improve the adenoma detection rate is valuable.
To answer the question of whether narrow-band imaging (NBI) can enhance detection quality in screening for colonoscopy.
A group of 533 patients (202 men: 331 women; average age: 56.1 years) included in a colorectal cancer screening program were randomised into two groups (NBI = 266 and white light (WL) = 267). Five hundred and twenty-seven patients were finally included in the assessment. Examinations were performed by three experienced colonoscopists. The NBI was used only at the withdrawal of the instrument.
Comparing WL and NBI colonoscopies, differences in the mean number of detected polyps per patient (1.36 ±2.79 WL vs. 1.65 ±2.11 NBI; = 0.012), polyp detection rate (PDR) (48.5% WL vs. 57.2% NBI; = 0.049), PDR for polyps ≤ 5 mm (44.7% WL vs. 54% NBI; = 0.033), and PDR for left-sided polyps (43.3% WL vs. 52.7% NBI; = 0.033) were observed. The difference in adenoma detection rate (ADR) as well as in adenomas/patient was not significant. Narrow-band imaging enhanced significantly one of three operators' ADR (15.6% WL vs. 25.7% NBI; = 0.038).
It seems that NBI improves only detection of hyperplastic polyps, especially those that are diminutive and left-sided. However, after analysis of particular endoscopists, it can clearly be seen that some of them may benefit from NBI.
腺瘤检测是结直肠癌筛查项目的基本目标；因此，提高腺瘤检测率的每一种可能性都很有价值。
回答窄带成像（NBI）是否能提高结肠镜筛查中的检测质量这一问题。
纳入一项结直肠癌筛查项目的533例患者（202例男性，331例女性；平均年龄：56.1岁）被随机分为两组（NBI组 = 266例，白光（WL）组 = 267例）。最终527例患者纳入评估。检查由三位经验丰富的结肠镜检查医师进行。NBI仅在退镜时使用。
比较WL和NBI结肠镜检查，观察到每位患者检测到的息肉平均数量存在差异（WL组为1.36±2.79个，NBI组为1.65±2.11个；P = 0.012），息肉检测率（PDR）存在差异（WL组为48.5%，NBI组为57.2%；P = 0.049），≤5 mm息肉的PDR存在差异（WL组为44.7%，NBI组为54%；P = 0.033），左侧息肉的PDR存在差异（WL组为43.3%，NBI组为52.7%；P = 0.033）。腺瘤检测率（ADR）以及每位患者的腺瘤数量差异不显著。窄带成像显著提高了三位操作者中一位的ADR（WL组为15.6%，NBI组为25.7%；P = 0.038）。
似乎NBI仅能提高增生性息肉的检测率，尤其是微小的左侧增生性息肉。然而，在对特定内镜医师进行分析后，可以清楚地看到他们中的一些人可能从NBI中受益。
