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Comparison of the detection of colorectal lesions in different endoscopic modalities: A network meta‑analysis and systematic review

  • Authors:
    • Lifu Li
    • Yinghua Ou
    • Hui Yue
    • Hong Sun
    • Peisheng Chen
    • Suying Liu
    • Fengjian He
    • Qianqian Peng
    • Sanhua Deng

  • View Affiliations

  • Published online on: April 30, 2019     https://doi.org/10.3892/etm.2019.7535
  • Pages: 154-162
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
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Abstract

A colonoscopy is considered to be the standard diagnostic test used to detect early colorectal lesions. Detection rates are expected to improve with optimised visualisation. A systematic review and network meta‑analysis was conducted to evaluate detection efficiency in several colonoscopic modalities. Relevant articles were identified in searches of the PubMed, EMBASE and Cochrane Library databases. The modalities, comprising of standard‑definition white light (SDWL), high‑definition white light (HDWL), narrow‑band imaging (NBI), autofluorescence imaging (AFI), PENTAX image enhanced technology (i‑SCAN), Fuji Intelligent Color Enhancement (FICE), dye‑based chromoendoscopy and novel image enhanced systems, including blue laser imaging (BLI) and linked color imaging (LCI), were compared to identify the most efficient modalities that could be used to detect colorectal lesions. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. As a result, 40 studies fulfilled the inclusion criteria. Overall, in the network meta‑analyses, NBI (OR, 1.29; 95% CI, 1.04‑1.58), FICE (OR, 1.39; 95% CI, 1.11‑1.77), chromoendoscopy (OR, 1.53; 95% CI, 1.22‑1.93) and AFI (OR, 1.81; 95% CI, 1.07‑2.87) were significantly better compared with SDWL at identifying adenoma in patients, and chromoendoscopy also proved significantly superior to HDWL (OR, 1.30; 95% CI, 1.06‑1.60). In pairwise analyses, it was demonstrated that chromoendoscopy was significantly superior to HDWL at detecting the number of polyps (MD, ‑1.11; 95% CI, ‑1.46, ‑0.76) and flat lesions (MD, ‑0.30; 95% CI, ‑0.49, ‑0.10) per subject. Additionally, FICE detected a significantly greater number of subjects with polyps (OR, 0.78; 95% CI, 0.64‑0.96) and NBI was significantly better at detecting the number of subjects with flat lesions (OR, 0.77; 95% CI, 0.60‑0.99) compared with HDWL. Based on the meta‑analysis, NBI, FICE and AFI were significantly better compared with SDWL at detecting patients with adenoma. Additionally, chromoendoscopy was significantly better than SDWL and HDWL at detecting the number of colorectal adenoma, however additional studies are needed to confirm these findings.
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July-2019
Volume 18 Issue 1

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Li L, Ou Y, Yue H, Sun H, Chen P, Liu S, He F, Peng Q and Deng S: Comparison of the detection of colorectal lesions in different endoscopic modalities: A network meta‑analysis and systematic review. Exp Ther Med 18: 154-162, 2019
APA
Li, L., Ou, Y., Yue, H., Sun, H., Chen, P., Liu, S. ... Deng, S. (2019). Comparison of the detection of colorectal lesions in different endoscopic modalities: A network meta‑analysis and systematic review. Experimental and Therapeutic Medicine, 18, 154-162. https://doi.org/10.3892/etm.2019.7535
MLA
Li, L., Ou, Y., Yue, H., Sun, H., Chen, P., Liu, S., He, F., Peng, Q., Deng, S."Comparison of the detection of colorectal lesions in different endoscopic modalities: A network meta‑analysis and systematic review". Experimental and Therapeutic Medicine 18.1 (2019): 154-162.
Chicago
Li, L., Ou, Y., Yue, H., Sun, H., Chen, P., Liu, S., He, F., Peng, Q., Deng, S."Comparison of the detection of colorectal lesions in different endoscopic modalities: A network meta‑analysis and systematic review". Experimental and Therapeutic Medicine 18, no. 1 (2019): 154-162. https://doi.org/10.3892/etm.2019.7535