在结肠胶囊内镜中安装的灵活光谱成像彩色增强对结直肠息肉和肿瘤的诊断产量的前瞻性研究。

Prospective study of diagnostic yields of flexible spectral imaging color enhancement installed in colon capsule endoscopy for colorectal polyps and tumors.

机构信息

Department of Gastroenterology, Fujita Health University, Toyoake, Japan.

Department of Gastroenterology, Fujita Health University, Toyoake, Japan; Department of Advanced Endoscopy, Fujita Health University, Toyoake, Japan.

出版信息

Gastrointest Endosc. 2024 Feb;99(2):245-253.e2. doi: 10.1016/j.gie.2023.09.002. Epub 2023 Oct 4.

DOI:10.1016/j.gie.2023.09.002

PMID:37797727

Abstract

BACKGROUND AND AIMS

We prospectively determined the efficacy of flexible spectral imaging color enhancement (FICE) used with second-generation colon capsule endoscopy (CCE) for colorectal polyps and tumors (CRTs).

METHODS

This study included optical colonoscopy within 4 months after CCE. Two colonoscopists independently reviewed CCE using white-light images (CCE-WL) and CCE using FICE images (CCE-FICE), respectively. Based on colonoscopic findings as the criterion standard, the diagnostic accuracy for CRTs was compared between CCE-WL and CCE-FICE.

RESULTS

Of 89 enrolled patients (65 men and 24 women; 75 with CRTs including 36 with serrated lesions, 63 with adenomas, and 9 with adenocarcinomas), the per-patient detectability of CCE-FICE for the representative CRTs was significantly higher than that of CCE-WL: overall CRTs (CCE-WL, 79%; CCE-FICE, 88%; P = .0001), 6- to 9-mm CRTs (CCE-WL, 63%; CCE-FICE, 94%; P = .0055), and ≥6-mm CRTs (CCE-WL, 78%; CCE-FICE, 93%; P = .0159). The per-lesion sensitivity of CCE-FICE was significantly higher than that of CCE-WL for CRTs: overall (CCE-WL, 61%; CCE-FICE, 79%; P < .0001), <6 mm (CCE-WL, 53%; CCE-FICE, 69%; P < .0001), 6- to 9-mm CRTs (CCE-WL, 65%; CCE-FICE, 93%; P = .0007), slightly elevated CRTs (CCE-WL, 53%; CCE-FICE, 75%; P < .0001), tubular adenomas (CCE-WL, 61%; CCE-FICE, 79%; P < .0001), and serrated polyps (CCE-WL, 57%; CCE-FICE, 74%; P = .0022). Both modes detected all adenocarcinomas. No significant differences were found between CCE-WL and CCE-FICE of the per-lesion sensitivity for ≥10-mm CRTs (CCE-WL, 81%; CCE-FICE, 94%; P = .1138) or protruding CRTs (CCE-WL, 77%; CCE-FICE, 86%; P = .0614). Kappa coefficients for overall CRTs for CCE-WL and CCE-FICE were .66 and .64, respectively, which indicated substantial agreement.

CONCLUSIONS

CCE-FICE improved the detection rates for all CRTs except adenocarcinomas, ≥10-mm polyps, and protruding polyps when compared with CCE-WL. (Clinical trial registration number: UMIN 000021125.).

摘要

背景与目的

我们前瞻性地确定了第二代结肠胶囊内镜（CCE）联合灵活光谱成像色彩增强（FICE）技术对结直肠息肉和肿瘤（CRTs）的疗效。

方法

本研究包括 CCE 检查后 4 个月内的光学结肠镜检查。两位结肠镜医师分别独立使用白光图像（CCE-WL）和 FICE 图像（CCE-FICE）对 CCE 进行检查。以结肠镜检查结果为标准，比较 CCE-WL 和 CCE-FICE 对 CRTs 的诊断准确性。

结果

共纳入 89 例患者（65 名男性和 24 名女性；75 例有 CRTs，其中 36 例为锯齿状病变，63 例为腺瘤，9 例为腺癌）。与 CCE-WL 相比，CCE-FICE 对代表性 CRTs 的每例患者检出率显著更高：总体 CRTs（CCE-WL，79%；CCE-FICE，88%；P=0.0001）、6-9mm CRTs（CCE-WL，63%；CCE-FICE，94%；P=0.0055）和≥6mm CRTs（CCE-WL，78%；CCE-FICE，93%；P=0.0159）。与 CCE-WL 相比，CCE-FICE 对 CRTs 的每例病变敏感性显著更高：总体（CCE-WL，61%；CCE-FICE，79%；P<0.0001）、<6mm（CCE-WL，53%；CCE-FICE，69%；P<0.0001）、6-9mm CRTs（CCE-WL，65%；CCE-FICE，93%；P=0.0007）、轻度隆起型 CRTs（CCE-WL，53%；CCE-FICE，75%；P<0.0001）、管状腺瘤（CCE-WL，61%；CCE-FICE，79%；P<0.0001）和锯齿状息肉（CCE-WL，57%；CCE-FICE，74%；P=0.0022）。两种模式均能检测出所有腺癌。对于≥10mm CRTs（CCE-WL，81%；CCE-FICE，94%；P=0.1138）或隆起型 CRTs（CCE-WL，77%；CCE-FICE，86%；P=0.0614），CCE-WL 和 CCE-FICE 的每例病变敏感性之间无显著差异。CCE-WL 和 CCE-FICE 对总体 CRTs 的 Kappa 系数分别为 0.66 和 0.64，表明存在中等程度的一致性。