Standard-definition White-light,High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas:A Multicenter Randomized Controlled Trial  

作　　者：Chang-wei DUAN Hui-hong ZHAI Hui XIE Xian-zong MA Dong-liang YU Lang YANG Xin WANG Yu-fen TANG Jie ZHANG Hui SU Jian-qiu SHENG Jun-feng XU Peng JIN 

机构地区：[1]Chinese PLA General Hospital and Medical School,Beijing,100853,China [2]Department of Gastroenterology,Xuanwu Hospital,Capital Medical University,Beijing,100053,China [3]Department of Gastroenterology,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,China [4]Senior Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,Beijing,100853,China

出　　处：《Current Medical Science》2024年第3期554-560,共7页当代医学科学（英文）

基　　金：supported by the Beijing Municipal Science and Technology Commission(BMSTC,No.D171100002617001).

摘　　要：Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese population.Methods This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority design.Patients undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December 2020.The primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma detected.The associated factors for detecting adenomas were assessed using univariate and multivariate logistic regression.Results Out of 653 eligible patients enrolled,data from 596 patients were analyzed.The ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese outpatients.It can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the future.Our study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.

关 键 词：standard-definition white-light endoscopy high-definition white-light endoscopy narrow-band imaging colonoscopy colorectal cancer screening adenoma detection rate 

分 类 号：R735.3[医药卫生—肿瘤]