联动成像技术联合透明帽辅助结肠镜检查对腺瘤检出率影响的研究

Study on the effect of linked color imaging combined with transparent cap assisted colonoscopy on the adenoma detection rate

目的探讨联动成像技术(linked color imaging,LCI)联合透明帽对结直肠腺瘤检出率的影响。方法共纳入2022年8月至2023年2月徐州市中心医院内镜中心行结肠镜检查的患者608例,随机分为WLI组(传统白光模式,white light imaging)、LCI组、透明帽组、LCI+透明帽组。所有结肠镜检查均由同一经验丰富的内镜医师完成,比较四组患者的基础临床资料、盲肠插管时间、腺瘤检出率、平均腺瘤检出数、阳性结肠镜平均腺瘤数等。结果WLI组、LCI组、透明帽组及LCI+透明帽组的腺瘤检出率分别为:33.3%、42.5%、37.3%、42.2%,LCI组、透明帽组、LCI+透明帽组分别与WLI组比较,腺瘤检出率差异无统计学意义(P>0.05)。WLI组、LCI组、透明帽组、LCI+透明帽组的近端腺瘤检出率分别为:10.4%、19.9%、16.0%、15.6%,LCI组较WLI组近端腺瘤检出率显著增加,差异有统计学意义(P<0.05);WLI组、LCI组、透明帽组、LCI+透明帽组的≤5 mm腺瘤检出率分别为:20.1%、25.3%、22.0%、30.6%,LCI+透明帽组较WLI组≤5 mm腺瘤检出率显著增加,差异有统计学意义(P<0.05)。LCI+透明帽组较WLI组阳性结肠镜平均腺瘤数显著增加(2.76±2.09 vs 1.96±1.38,P<0.05);LCI组、LCI联合透明帽组较WLI组平均腺瘤检出数显著增加(1.05±1.90 vs 0.65±1.22,P<0.05;1.16±1.92 vs 0.65±1.22,P<0.01)。结论LCI联合透明帽辅助结肠镜检查提高了≤5 mm腺瘤检出率,且可以提高平均腺瘤检出数以及阳性结肠镜平均腺瘤数。

Objective To explore the effect of linked color imaging(LCI)combined with transparent cap on the adenoma detection rate.Methods A total of 608 patients undergoing colonoscopy in the Endoscopic Center of Xuzhou Central Hospital from Aug.2022 to Feb.2023 were enrolled and randomly divided into WLI(white light imaging)group,LCI group,transparent cap group,and LCI+transparent cap group.All colonoscopies were performed by the same experienced endoscopist.The basic clinical data,time of ileocecal valve insertion,adenoma detection rate,average number of adenomas detected,and adenomas per positive index colonoscopy of the four groups were compared.Results The adenoma detection rates in WLI group,LCI group,transparent cap group and LCI+transparent cap group were 33.3%,42.5%,37.3%and 42.2%,respectively.When comparing the adenoma detection rates in LCI group,transparent cap group and LCI+transparent cap group with those in WLI group,no statistically significant differences were found(P>0.05).The detection rates of proximal adenomas in WLI group,LCI group,transparent cap group and LCI+transparent cap group were 10.4%,19.9%,16.0%and 15.6%,respectively.The detection rate of proximal adenomas in LCI group was significantly higher than that in WLI group,and the difference was statistically significant(P<0.05).The detection rates of adenomas≤5 mm in WLI group,LCI group,transparent cap group and LCI+transparent cap group were 20.1%,25.3%,22.0%and 30.6%,respectively.The detection rate of adenomas≤5 mm in LCI+transparent cap group was significantly higher than that in WLI group,and the difference was statistically significant(P<0.05).The average number of adenomas per positive index colonoscopy was significantly higher in LCI+transparent cap group than that in WLI group(2.76±2.09 vs 1.96±1.38,P<0.05).The average number of adenomas per colonoscopy was significantly higher in LCI group and LCI+transparent cap group than that in the WLI group(1.05±1.90 vs 0.65±1.22,P<0.05;1.16±1.92 vs 0.65±1.22,P<0.01).Conclusion LCI combined with transparent cap assisted colonoscopy improves the detection rate of≤5 mm adenomas and can increase the mean number of adenomas detected as well as the adenomas per positive index colonoscopy.