Department of Internal Medicine, CHA Gumi Medical Center, CHA University, Gyeongsangbuk-do, South Korea.
Eur Rev Med Pharmacol Sci. 2023 Apr;27(8):3552-3564. doi: 10.26355/eurrev_202304_32129.
It is unclear whether photodocumentation is associated with colorectal neoplasm (CRN) detection at colonoscopy, despite its ability to take more images with the development of affordable digital imaging systems. This study aimed to investigate whether photodocumentation-related factors could affect the detection rate of CRNs in healthy subjects.
A total of 2,637 subjects undergoing screening colonoscopy in routine health check-ups at CHA Bundang Medical from January to September 2016 were enrolled in this study. Only the endoscopic image data for observation purposes during colonoscopy withdrawal was used in this analysis. The number of observation images, observation time and the speed of photodocumentation (SPD) defined as the number of observation images per minute were used as quantity measures of photodocumentation. The presence of documented anatomical landmarks such as appendix orifice (AO), ileocecal valve (ICV), anorectal junction was used as quality measures of photodocumentation.
Among subject-related factors, the independent factors for CRN detection in the multivariate analysis were age, male sex, waist circumference, and family history of colorectal cancer. In photo-documentation-related factors, SPD [Odds ratio (OR) 0.800; 95% confidence interval (CI), 0.740 to 0.864], observation time over 6 min (OR 1.671; 95% CI, 1.145 to 2.439), clear documentation of appendix orifice (AO) (OR 5.976; 95% CI, 4.548 to 7.852) and ileocecal valve (ICV) (OR 3.826; 95% CI, 2.985 to 4.904), and endoscopists (p < 0.001) were independently significant factors. However, the number of observation images was not associated with the detection of CRNs.
Lower SPD and clear documentation of cecal landmarks might be associated with an increased detection rate of CRNs.
尽管随着经济实惠的数字成像系统的发展，其能够拍摄更多的图像，但摄影记录是否与结肠镜检查中的结直肠肿瘤（CRN）检测相关仍不清楚。本研究旨在调查摄影记录相关因素是否会影响健康受试者中 CRN 的检测率。
本研究共纳入 2016 年 1 月至 9 月在 CHA 盆唐医疗中心进行常规健康检查的 2637 例筛查结肠镜检查患者。本分析仅使用结肠镜检查退镜过程中观察目的的内镜图像数据。观察图像数量、观察时间和摄影速度（SPD）定义为每分钟观察图像数量，作为摄影记录的数量测量指标。记录解剖学标志（如阑尾口（AO）、回盲瓣（ICV）、肛直肠交界处）的存在与否作为摄影记录的质量测量指标。
在受试者相关因素中，多变量分析中 CRN 检测的独立因素为年龄、男性、腰围和结直肠癌家族史。在摄影记录相关因素中，SPD[比值比（OR）0.800；95%置信区间（CI）0.740 至 0.864]、观察时间超过 6 分钟（OR 1.671；95%CI，1.145 至 2.439）、AO（OR 5.976；95%CI，4.548 至 7.852）和 ICV（OR 3.826；95%CI，2.985 至 4.904）的清晰记录以及内镜医师（p<0.001）均为独立的显著因素。然而，观察图像的数量与 CRN 的检测无关。
较低的 SPD 和回盲部解剖标志的清晰记录可能与 CRN 的检测率增加相关。
