林奇综合征患者基于染料的色素内镜检查：一项随机试验的个体患者数据荟萃分析
Dye-Based Chromoendoscopy in Patients With Lynch Syndrome: An Individual Patient Data Meta-Analysis of Randomized Trials.
作者信息
Houwen Britt B S L, Mostafavi Nahid, Vleugels Jasper L A, Hüneburg Robert, Lamberti Christof, Rivero-Sánchez Liseth, Pellisé María, Stoffel Elena M, Syngal Sapna, Haanstra Jasmijn F, Koornstra Jan J, Dekker Evelien, Hazewinkel Yark
机构信息
1Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam Cancer Center, University of Amsterdam, Amsterdam, the Netherlands; 2Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 3Department of Internal Medicine, University of Bonn, Bonn, Germany; 4National Center for Hereditary Tumor Syndromes, University Hospital Bonn, Bonn, Germany; 5Department of Hematology and Oncology, Klinikum Coburg, Coburg, Germany; 6Department of Gastroenterology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universitat de Barcelona, Barcelona, Spain; 7Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA; 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; 9Division of Cancer Genetics and Prevention, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA; 10Harvard Medical School, Boston, Massachusetts, USA; 11Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 12Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Radboud University of Nijmegen, Nijmegen, the Netherlands.
出版信息
Am J Gastroenterol. 2021 Apr;116(4):825-828. doi: 10.14309/ajg.0000000000001138.
INTRODUCTION
The additional diagnostic value of dye-based chromoendosocpy (CE) for surveillance of patients with Lynch syndrome is subject of debate.
METHODS
To clarify this debate, we performed an individual patient data meta-analysis of randomized studies that compared CE with WLE for the detection of adenomas in patients with Lynch syndrome.
RESULTS
Three randomized studies comprising 533 patients were included. The adenoma detection rate was 74/265 (28%) in patients randomized to WLE compared with 83/266 (31%) in patients randomized to CE (odds ratio 1.17; 95% confidence interval 0.81-1.70).
DISCUSSION
Based on low-quality evidence, CE showed no apparent increase in adenoma detection compared to WLE during surveillance of patients with Lynch syndrome.
引言
基于染料的色素内镜检查（CE）对林奇综合征患者进行监测的额外诊断价值存在争议。
方法
为了阐明这一争议，我们对随机研究进行了个体患者数据荟萃分析，比较了CE与白光内镜检查（WLE）在检测林奇综合征患者腺瘤方面的效果。
结果
纳入了三项包含533例患者的随机研究。随机接受WLE的患者腺瘤检出率为74/265（28%），而随机接受CE的患者为83/266（31%）（优势比1.17；95%置信区间0.81-1.70）。
讨论
基于低质量证据，在对林奇综合征患者进行监测时，与WLE相比，CE并未显示出腺瘤检出率有明显提高。
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