Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
BMJ Open Gastroenterol. 2020 Sep;7(1). doi: 10.1136/bmjgast-2020-000494.
Wide-area transepithelial sampling (WATS) is a new technique that uses an abrasive brush to obtain samples from a larger surface area of the oesophagus. Studies have shown promising results that WATS in adjunct to forceps biopsy (FB) increases the detection rate of Barrett's oesophagus (BE) as well as oesophageal dysplasia (ED). We conducted a systematic review and meta-analysis to compare the detection rates of BE and ED between FB and WATS in adjunct to FB.
A Literature search was done using electronic databases, including PubMed, Embase, Scopus, Cochrane and CINAHL from inception to 26 April 2020. A meta-analysis comparing detection rates of WATS in adjunct to FB versus FB using the random-effects model was done using RevMan V.5.3.
Pooled data from 20 392 endoscopies across 11 studies showed an absolute increase in detection of 16% (95% CI 0.10% to 0.22%, p<0.00001). A relative increase of 1.62 was seen in detection rates of BE (95% CI 1.28 to 2.05, p<0.0001) when WATS was used with FB with the number needed to test (NNT) of 6.1 patients. For ED, a 2% absolute increase (95% CI 0.01 to 0.03, p=0.001) in additional diagnostic yield from WATS. A relative increase of 2.05 was seen in the detection rate of ED (95% CI 1.42 to 2.98, p=0.0001) yielding an NNT of 50 patients.
Our study shows that WATS, as an adjunct to FB, improves both the absolute detection rate and relative detection rate of both BE and ED as compared to FB alone.
广域跨上皮采样（WATS）是一种新的技术，它使用磨蚀刷从食管的更大表面积获取样本。研究表明，WATS 联合活检钳（FB）增加了 Barrett 食管（BE）和食管发育不良（ED）的检出率，结果很有前景。我们进行了一项系统评价和荟萃分析，比较了 FB 联合 WATS 与 FB 单独检查时 BE 和 ED 的检出率。
从 2020 年 4 月 26 日起，通过电子数据库（包括 PubMed、Embase、Scopus、Cochrane 和 CINAHL）进行文献检索。使用 RevMan V.5.3 对使用随机效应模型比较 FB 联合 WATS 与 FB 检查时 WATS 检出率的荟萃分析数据进行汇总。
来自 11 项研究的 20392 例内镜检查的汇总数据显示，BE 检出率绝对增加了 16%（95%CI 0.10%至 0.22%，p<0.00001）。与 FB 单独检查相比，WATS 联合 FB 检查时 BE 的检出率相对增加了 1.62（95%CI 1.28 至 2.05，p<0.0001），需要检查的患者数（NNT）为 6.1 例。对于 ED，WATS 可使诊断增益增加 2%（95%CI 0.01 至 0.03，p=0.001）。ED 的检出率相对增加了 2.05（95%CI 1.42 至 2.98，p=0.0001），NNT 为 50 例。
我们的研究表明，与 FB 单独检查相比，WATS 联合 FB 可提高 BE 和 ED 的绝对检出率和相对检出率。
