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

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外文摘要：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.

外文关键词：

standard-definition white-light endoscopyhigh-definition white-light endoscopynarrow-band imaging colonoscopycolorectal cancer screeningadenoma detection rate

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

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作者单位：

Chinese PLA General Hospital and Medical School,Beijing 100853,China

Department of Gastroenterology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China

Department of Gastroenterology,The Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China

Senior Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China

Senior Department of Gastroenterology,the First Medical Center of Chinese PL A General Hospital,Beijing 100853,China

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出版年：

2024

DOI：

10.1007/s11596-024-2882-2

当代医学科学(英文)

华中科技大学同济医学院

当代医学科学(英文)

影响因子：0.748

ISSN：2096-5230

年,卷(期)：2024.44(3)