The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310060, China.
Surg Endosc. 2024 Oct;38(10):5903-5913. doi: 10.1007/s00464-024-11186-y. Epub 2024 Aug 21.
Most endoscopists believe that higher resolution improves lesion detection rates. However, existing studies primarily compared the detection rates of white light endoscopy (WLE) and other imaging modalities. Our previous study demonstrated the advantages of magnifying endoscopy from general endoscopy for lesion detection, prompting further investigation into the variations in lesion detection rates across endoscopes with different resolutions.
Endoscopic and corresponding pathological data from our medical unit over the past 5 years were analyzed. We excluded specific-purpose endoscopic procedures to ensure the natural randomization of the data. Baseline adjustment and risk factor analyses used multi-group propensity score matching and logistic regression.
The overall lesion detection rate was significantly higher with high-quality endoscopy (Q-endoscopy) compared to high-definition endoscopy (H-endoscopy) and high definition and quality endoscopy (HQ-endoscopy) (34.4% vs. 30.2% vs. 29.6%, P = 0.001). Similar results were observed for elevated lesions (25.7% vs. 21.0% vs. 22.9%, P = 0.001) and depressed lesions (6.6% vs. 6.2% vs. 3.6%, P < 0.001). HQ-endoscopy had a superior detection rate for superficial lesions compared to both H- and Q-endoscopies (3.0% vs. 2.8% vs. 1.8%, P = 0.041). However, there were no significant differences in neoplastic detection rate or missed neoplastic lesion rate among the three groups.
Q-endoscopy is superior in detecting non-superficial lesions, while HQ-endoscopy is better at detecting superficial lesions. However, there were no statistically significant differences in detecting or omitting neoplastic lesions among the three endoscopic examinations.
大多数内镜医师认为更高的分辨率可提高病变检出率。然而，现有研究主要比较了白光内镜（WLE）和其他成像方式的检出率。我们之前的研究表明，放大内镜相对于普通内镜在病变检出方面具有优势，这促使我们进一步研究不同分辨率的内镜在病变检出率方面的差异。
分析了过去 5 年我们医疗单位的内镜和相应的病理数据。我们排除了特定目的的内镜检查，以确保数据的自然随机性。使用多组倾向评分匹配和逻辑回归进行基线调整和危险因素分析。
高质量内镜（Q-内镜）的总体病变检出率明显高于高清内镜（H-内镜）和高清及高质量内镜（HQ-内镜）（34.4%比 30.2%比 29.6%，P=0.001）。隆起性病变（25.7%比 21.0%比 22.9%，P=0.001）和凹陷性病变（6.6%比 6.2%比 3.6%，P<0.001）也观察到了类似的结果。HQ-内镜对浅层病变的检出率优于 H-和 Q-内镜（3.0%比 2.8%比 1.8%，P=0.041）。然而，三组之间的肿瘤检出率或肿瘤漏诊率无显著差异。
Q-内镜在检测非浅层病变方面更优，而 HQ-内镜在检测浅层病变方面更好。然而，在三种内镜检查中，在检测或遗漏肿瘤病变方面没有统计学上的显著差异。
