智能分光比色技术与靛胭脂染色大肠镜检查随机对照试验Meta分析

Flexible spectral imaging color enhancement versus indigo carmine staining following colonoscopy: meta-analysis of randomized controlled trials

摘要:

目的??系统分析比较智能分光比色技术（FICE）与靛胭脂染色（IC）对提高大肠病变检出率的临床运用价值。方法?使用以下关键词：“flexible spectral imaging color enhancement”，“indigo carmine”，“colonoscope”，“colonic lesions”，“colon tumor”、“chromoendoscopy”、“虚拟色素内镜”、“靛胭脂质”、“结肠镜”、“色素内镜”、“结肠病变”、“结肠癌”、“结肠息肉”和“灵活的光谱成像色彩增强”检索PubMed、CINAHL数据库、万方数据库、维普数据库、中国知网和Cochrane图书馆数据库2008年1月-2013年1月之间的相关文章，通过排除最终纳入8篇文章，所有的数据进行了分析。结果?用比值比（OR）结果的95%可信区间（CI）评估的检测方法和检测率之间的相关性。肿瘤病变（OR=0.90，95%CI：0.76～1.08，P =0.255）、非肿瘤性病变（OR=1.09，95%CI：0.92～1.30，P =0.302）、腺瘤（OR=0.87，95%CI：0.72～1.07，P =0.188）、非肿瘤性息肉（OR=0.84，95%CI：0.67～1.06，P =0.146）、平坦型病变（OR=0.87，95%CI：0.71～1.08，P =0.203）、隆起性病变（OR=1.23，95%CI：0.93～1.64，P =0.153）、右半结肠病变（OR=0.83，95%CI：0.60～1.14，P =0.251）、横向结肠病变（OR=0.71，95%CI：0.48～1.05，P =0.086），两者左半结肠病变（OR=1.35，95%CI：1.01～1.80，P =0.045）之间比较，差异具有统计学意义。结论?除了左半结肠的病变以外，FICE和IC之间的结肠病变检测率差异无统计学意义。

Abstract:

Objective?To assess whether FICE or IC is more effective at detecting colonic diseases.?Method?We searched PubMed, CINAHL, CQVIP and the Cochrane Library databases for relevant papers published between January 2008 and August 2013 using the following keywords: flexible spectral imaging color enhancement, indigo carmine, colonoscope, colonic lesions, colon tumor and chromoendoscopy. We included eight articles, and all data were subdivided for analysis.?Results?We used odds ratios (ORs) with 95 % confidence intervals (CIs) to assess correlations between the detection methods and detection rates. The detection rates did not significantly differ between FICE and IC for colonic tumor lesions (OR = 0.90, 95 % CI: 0.76 ~ 1.08, P = 0.255), non-tumor lesions (OR = 1.09, 95 % CI: 0.92 ~ 1.30, P = 0.302), adenomas (OR = 0.87, 95 % CI: 0.72 ~ 1.07, P = 0.188), non-neoplastic polyps (OR = 0.84, 95 % CI: 0.67 ~ 1.06, P = 0.146), flat lesions (OR = 0.87, 95 % CI: 0.71 ~ 1.08, P = 0.203), protruded lesions (OR= 1.23, 95 % CI: 0.93 ~ 1.64, P = 0.153), right colon lesions (OR = 0.83, 95 % CI: 0.60 ~ 1.14, P = 0.251), transverse colon lesions (OR = 0.71, 95 % CI: 0.48~1.05, P = 0.086), or left colon lesions (OR = 1.35, 95 % CI: 1.01 ~ 1.80, P = 0.045).?Conclusions?There were no significant differences in the rate of colonic lesion detection between FICE and IC except the left colon. Therefore, providers should choose a suitable inspection method based on the resources of the hospital.