Department of General Internal Medicine, Saitama Medical University, Saitama, Japan.
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.
J Gastroenterol Hepatol. 2021 Oct;36(10):2778-2784. doi: 10.1111/jgh.15539. Epub 2021 May 20.
The adenoma detection rate is an important indicator of colonoscopy quality and colorectal cancer incidence. We compared the adenoma detection rates between white light imaging (WLI) and linked color imaging (LCI) colonoscopy.
Patients undergoing colonoscopy for positive fecal immunochemical tests, follow-up of colon polyps, and abdominal symptoms at three institutions were randomly assigned to the LCI or WLI groups. Mean adenoma number per patient (including based on endoscopists' experience), adenoma detection rate, cecal intubation time, withdrawal time, mean adenoma number per location, and adenoma size were compared.
The LCI and WLI groups comprised 494 and 501 patients, respectively. No significant differences in the cecal intubation rate (LCI vs WLI: 99.5% vs 99.4%), cecal intubation time, and withdrawal time were noted between groups. The mean adenoma number per patient was significantly higher in the LCI group than in the WLI group (1.07 vs 0.88, P = 0.04), particularly in the descending [0.12 (58/494) vs 0.07 (35/501), P = 0.01] and sigmoid colon [0.41 (201/494) vs 0.30 (149/501), P ≤ 0.001]. However, the adenoma detection rate was 47.1% in the LCI group and 46.9% in the WLI group, with no significant difference (P = 0.93). The total number of sessile-type adenomas was significantly higher in the LCI group than in the WLI group (346/494 vs 278/501, P = 0.04). As for polyp size, small polyps (≤ 5 mm) were detected at a significantly higher rate in the LCI group (271/494 vs 336/501, P = 0.04).
Linked color imaging is significantly superior to WLI in terms of mean adenoma number per patient.
腺瘤检出率是结肠镜质量和结直肠癌发病率的重要指标。我们比较了白光成像（WLI）和链接色成像（LCI）结肠镜检查的腺瘤检出率。
在三个机构中，接受阳性粪便免疫化学试验、结直肠息肉随访和腹部症状的患者被随机分配到 LCI 或 WLI 组。比较每位患者的平均腺瘤数（包括根据内镜医生的经验）、腺瘤检出率、盲肠插管时间、退出时间、每个部位的平均腺瘤数和腺瘤大小。
LCI 和 WLI 组分别纳入 494 例和 501 例患者。两组盲肠插管率（LCI 与 WLI：99.5%与 99.4%）、盲肠插管时间和退出时间无显著差异。LCI 组每位患者的平均腺瘤数明显高于 WLI 组（1.07 比 0.88，P=0.04），尤其是在降结肠[0.12（58/494）比 0.07（35/501），P=0.01]和乙状结肠[0.41（201/494）比 0.30（149/501），P≤0.001]。然而，LCI 组的腺瘤检出率为 47.1%，WLI 组为 46.9%，差异无统计学意义（P=0.93）。LCI 组的无蒂腺瘤总数明显高于 WLI 组（346/494 比 278/501，P=0.04）。至于息肉大小，LCI 组较小息肉（≤5mm）的检出率明显较高（271/494 比 336/501，P=0.04）。
与 WLI 相比，链接色成像在每位患者的平均腺瘤数方面具有显著优势。
