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光学增强模式 2 提高高危人群胃肿瘤病变的检出率:一项多中心随机对照临床研究。

Optical enhancement mode 2 improves the detection rate of gastric neoplastic lesion in high-risk populations: A multicenter randomized controlled clinical study.

机构信息

Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.

Department of Gastroenterology, Peking University Cancer Hospital, Beijing, China.

出版信息

United European Gastroenterol J. 2024 Jul;12(6):772-779. doi: 10.1002/ueg2.12577. Epub 2024 May 16.

Abstract

OBJECTIVES

Detection of early neoplastic lesions is crucial for improving the survival rates of patients with gastric cancer. Optical enhancement mode 2 is a new image-enhanced endoscopic technique that offers bright images and can improve the visibility of neoplastic lesions. This study aimed to compare the detection of neoplastic lesions with optical enhancement mode 2 and white-light imaging (WLI) in a high-risk population.

METHODS

In this prospective multicenter randomized controlled trial, patients were randomly assigned to optical enhancement mode 2 or WLI groups. Detection of suspicious neoplastic lesions during the examinations was recorded, and pathological diagnoses served as the gold standard.

RESULTS

A total of 1211 and 1219 individuals were included in the optical enhancement mode 2 and WLI groups, respectively. The detection rate of neoplastic lesions was significantly higher in the optical enhancement mode 2 group (5.1% vs. 1.9%; risk ratio, 2.656 [95% confidence interval, 1.630-4.330]; p < 0.001). The detection rate of neoplastic lesions with an atrophic gastritis background was significantly higher in the optical enhancement mode 2 group (8.6% vs. 2.6%, p < 0.001). The optical enhancement mode 2 group also had a higher detection rate among endoscopists with different experiences.

CONCLUSIONS

Optical enhancement mode 2 was more effective than WLI for detecting neoplastic lesions in the stomach, and can serve as a new method for screening early gastric cancer in clinical practice.

CLINICAL REGISTRY

United States National Library of Medicine (https://www.

CLINICALTRIALS

gov), ID: NCT040720521.

摘要

目的

检测早期肿瘤病变对于提高胃癌患者的生存率至关重要。光学增强模式 2 是一种新的图像增强内镜技术,可提供明亮的图像,并提高肿瘤病变的可视性。本研究旨在比较光学增强模式 2 与白光成像(WLI)在高危人群中对肿瘤病变的检测效果。

方法

在这项前瞻性多中心随机对照试验中,患者被随机分配到光学增强模式 2 组或 WLI 组。记录检查过程中可疑肿瘤病变的检出情况,并以病理诊断为金标准。

结果

光学增强模式 2 组和 WLI 组分别纳入 1211 例和 1219 例患者。光学增强模式 2 组肿瘤病变的检出率显著更高(5.1%比 1.9%;风险比,2.656[95%置信区间,1.630-4.330];p<0.001)。光学增强模式 2 组在萎缩性胃炎背景下肿瘤病变的检出率也显著更高(8.6%比 2.6%,p<0.001)。光学增强模式 2 组在不同经验内镜医师中也具有更高的检出率。

结论

光学增强模式 2 比 WLI 更有效地检测胃内肿瘤病变,可作为临床实践中筛查早期胃癌的新方法。

临床注册号

美国国立医学图书馆(https://www.clinicaltrials.gov),编号:NCT040720521。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8dc/11250407/cdc1cf59d179/UEG2-12-772-g001.jpg

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