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Gastroenterology:窄带成像内镜可提高结肠镜腺瘤检出率

2019-04-17 MedSci MedSci原创

在随机对照试验中对个别患者的数据进行的荟萃分析后,研究发现NBI的ADR高于WLE,当肠道准备是最佳的时候,这种效果更大

腺瘤检出率(ADR)是结肠镜检查的重要质量指标。先前的研究认为,在肠道准备最佳时,窄带成像(NBI)可能比白光内镜(WLE)更有效地检测腺瘤。近日研究人员对随机对照试验中单个患者的数据进行了荟萃分析,比较了NBI和WLE检测腺瘤的效果。

研究人员收集截至2017年4月在Medline、EMBASE和Cochrane数据库中收录的随机对照试验,这些试验评估了高清晰度WLE和NBI检测结肠息肉的情况。研究的主要终点是肠道准备质量调整后的ADR。

11个临床研究纳入本次荟萃分析,包括4491名患者和6636例检测出息肉。2251人进行了WLE检查,检出腺瘤952例(42.3%)。

2239人进行NBI检查,检出腺瘤1011例(45.2%)(接受WLE与NBI检查腺瘤的未调整的优势比[OR]=1.14,95%CI:1.01-1.29,P=0.04)。仅当肠道准备最好时,NBI检查率优于WLE检查:充分准备OR为1.07(95%CI:0.92-1.24;P=0.38)而最佳准备OR=1.30(95%CI:1.04-1.62;P=0.02)。第二代NBI的ADR高于WLE。(第二代NBI OR=1.28,95%CI:1.05-1.56,P=0.02),而第一代却没有。NBI检测到的非腺瘤性息肉(OR=1.24,95%CI:1.06-1.44,P=0.008)和扁平息肉(OR=1.24,95%CI:1.02-1.51,P=0.03)多于WLE。

在随机对照试验中对个别患者的数据进行的荟萃分析后,研究发现NBI的ADR高于WLE,当肠道准备是最佳的时候,这种效果更大。

原始出处:


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  5. [GetPortalCommentsPageByObjectIdResponse(id=2064696, encodeId=5719206469695, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Mar 20 14:10:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041484, encodeId=7ca020414846c, content=<a href='/topic/show?id=e63be556197' target=_blank style='color:#2F92EE;'>#窄带成像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75561, encryptionId=e63be556197, topicName=窄带成像)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Fri May 31 22:10:00 CST 2019, time=2019-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711918, encodeId=e0661e11918c9, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Apr 27 16:10:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2004008, encodeId=2b4c200400871, content=<a href='/topic/show?id=57a285e29a0' target=_blank style='color:#2F92EE;'>#腺瘤检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85729, encryptionId=57a285e29a0, topicName=腺瘤检出率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c82369, createdName=jiekemin, createdTime=Sun Oct 13 03:10:00 CST 2019, time=2019-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1904804, encodeId=bd58190480477, content=<a href='/topic/show?id=ae97625036d' target=_blank style='color:#2F92EE;'>#检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62503, encryptionId=ae97625036d, topicName=检出率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Wed May 01 15:10:00 CST 2019, time=2019-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072538, encodeId=c49b20e253878, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, 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authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524086, encodeId=e8171524086e8, content=<a href='/topic/show?id=1d1281e50e0' target=_blank style='color:#2F92EE;'>#肠镜腺瘤检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81750, encryptionId=1d1281e50e0, topicName=肠镜腺瘤检出率)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a92c11571309, createdName=xiaoyeshuang, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2064696, encodeId=5719206469695, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Mar 20 14:10:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041484, encodeId=7ca020414846c, content=<a href='/topic/show?id=e63be556197' target=_blank style='color:#2F92EE;'>#窄带成像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75561, encryptionId=e63be556197, topicName=窄带成像)], attachment=null, authenticateStatus=null, createdAvatar=null, 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href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504657, encodeId=acfd150465ee2, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524086, encodeId=e8171524086e8, content=<a href='/topic/show?id=1d1281e50e0' target=_blank style='color:#2F92EE;'>#肠镜腺瘤检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81750, encryptionId=1d1281e50e0, topicName=肠镜腺瘤检出率)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a92c11571309, createdName=xiaoyeshuang, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=)]
    2019-12-03 许安
  7. 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authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524086, encodeId=e8171524086e8, content=<a href='/topic/show?id=1d1281e50e0' target=_blank style='color:#2F92EE;'>#肠镜腺瘤检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81750, encryptionId=1d1281e50e0, topicName=肠镜腺瘤检出率)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a92c11571309, createdName=xiaoyeshuang, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2064696, encodeId=5719206469695, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Mar 20 14:10:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041484, encodeId=7ca020414846c, content=<a href='/topic/show?id=e63be556197' target=_blank style='color:#2F92EE;'>#窄带成像#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75561, encryptionId=e63be556197, topicName=窄带成像)], attachment=null, authenticateStatus=null, createdAvatar=null, 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href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504657, encodeId=acfd150465ee2, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524086, encodeId=e8171524086e8, content=<a href='/topic/show?id=1d1281e50e0' target=_blank style='color:#2F92EE;'>#肠镜腺瘤检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81750, encryptionId=1d1281e50e0, topicName=肠镜腺瘤检出率)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a92c11571309, createdName=xiaoyeshuang, createdTime=Thu Apr 18 21:10:00 CST 2019, time=2019-04-18, status=1, ipAttribution=)]
    2019-04-18 zhouqu_8
  9. 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  10. 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