Hashimoto Hikaru, Yoshida Naohisa, Inagaki Yoshikazu, Fukumoto Kohei, Hasegawa Daisuke, Okuda Kotaro, Tomie Akira, Yasuda Ritsu, Morimoto Yasutaka, Murakami Takaaki, Inada Yutaka, Tomita Yuri, Kobayashi Reo, Inoue Ken, Hirose Ryohei, Dohi Osamu, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Gastroenterology, Nishijin Hospital, Kyoto, Japan.
Endosc Int Open. 2024 Oct 10;12(10):E1092-E1101. doi: 10.1055/a-2399-7554. eCollection 2024 Oct.
We previously demonstrated the efficacy of an additional-30-seconds (Add-30s) observation with linked color imaging (LCI) or narrow band imaging (NBI) of the cecum and ascending colon (right-sided colon) after white light imaging (WLI) observation for improving adenoma detection rate (ADR) by 3% to 10%. We herein compared Add-30s LCI with Add-30s NBI in a large number of cases. We retrospectively collected 1023 and 1011 cases with Add-30s LCI and NBI observation for right-sided colon in 11 affiliated institutions from 2018 to 2022 and propensity score matching was performed. Add-30s observation was as follows. First observation: WLI observation of the right-sided colon as first observation. Second observation: Reobservation of right-sided colon by Add-30s LCI or NBI. The comparison of the mean numbers of adenoma+sessile serrated lesions (SSLs) and adenomas per patient (MASP and MUTYH-associated polyposis) were analyzed in the Add-30s LCI/NBI groups. The increase in right-sided ADR was also analyzed in the groups. Among 748 matched cases in the Add-30s LCI/NBI groups, the MASP and MAP were 0.18/0.19 ( = 0.54) and 0.14/0.15 ( = 0.70). Among experts, they were 0.17/0.22 ( = 0.16) and 0.15/0.21 ( = 0.08). Among non-experts, they were 0.13/0.12 ( = 0.71) and 0.12/0.07 ( = 0.04). The right-sided ADRs of the first+second observations in the LCI and NBI groups were 32.2% and 28.9% ( = 0.16) and the increase of ADRs were 7.5% and 7.2% ( = 0.84). In right-sided colon, the detection of adenoma/SSL did not differ between Add-30s LCI and NBI. Both of them significantly increased ADR.
我们之前证明了在白光成像（WLI）观察后，对盲肠和升结肠（右侧结肠）进行额外30秒的联动彩色成像（LCI）或窄带成像（NBI）观察，可将腺瘤检出率（ADR）提高3%至10%。我们在大量病例中比较了额外30秒LCI与额外30秒NBI。我们回顾性收集了2018年至2022年期间11家附属医院1023例和1011例接受额外30秒LCI和NBI右侧结肠观察的病例，并进行了倾向评分匹配。额外30秒观察如下。首次观察：将右侧结肠的WLI观察作为首次观察。第二次观察：通过额外30秒LCI或NBI对右侧结肠进行再次观察。在额外30秒LCI/NBI组中分析了每位患者腺瘤+无蒂锯齿状病变（SSL）和腺瘤（MASP和MUTYH相关息肉病）的平均数量比较，并分析了两组中右侧ADR的增加情况。在额外30秒LCI/NBI组的748例匹配病例中，MASP和MAP分别为0.18/0.19（P = 0.54）和0.14/0.15（P = 0.70）；在专家中分别为0.17/0.22（P = 0.16）和0.15/0.21（P = 0.08）；在非专家中分别为0.13/0.12（P = 0.71）和0.12/0.07（P = 0.04）。LCI组和NBI组首次+第二次观察的右侧ADR分别为32.2%和28.9%（P = 0.16），ADR增加分别为7.5%和7.2%（P = 0.84）。在右侧结肠中，额外30秒LCI和NBI对腺瘤/SSL的检测无差异。两者均显著提高了ADR。
