High resolution colonoscopy with chromoscopy versus standard colonoscopy for the detection of colonic neoplasia: A randomized study

被引:117
作者
Le Rhun, M
Ccron, E
Parlier, D
Nguyen, JM
Canard, JM
Alamdari, A
Sautereau, D
Chaussade, S
Galmiche, JP [1 ]
机构
[1] Univ Hosp, Hotel Dieu, Inst Digest Dis, F-44000 Nantes, France
[2] Hop Cochin, Dept Gastroenterol, F-75674 Paris, France
[3] Univ Hosp, Dept Biostat, Nantes, France
[4] Croix Rouge, Serv Dept Gastroenterol, Paris, France
[5] Univ Hosp, Dept Gastroenterol, Limoges, France
关键词
D O I
10.1016/j.cgh.2005.12.009
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: High-resolution colonoscopy with chromoscopy (HRC) is a technique designed to improve the detection of colonic neoplasias. We prospectively compared standard colonoscopy (SC) and HRC in a randomized multicenter trial. Methods: Patients (n = 203; age, 58 +/- 10 years; sex ratio, (1) were recruited according to the following criteria: (1) a history of either familial or personal colonic neoplasia or (2) alarm symptoms after the age of 60 years. After randomization, an SC was performed in 100 patients (resolution, <= 410,000 pixels) and a HRC in 103 patients (Fujinon EC485ZW, 850,000 pixels). In the HRC group, each colonic segment was examined before and after spraying with indigo carmine 0.4%. Results: Two hundred seventy-six polyps were detected in 198 patients. One hundred sixty of them were hyperplastic polyps, 116 were adenomas, and 2 were carcinomas. The numbers of hyperplastic polyps and purely flat adenomas were significantly higher in the HRC group than in the SC group (1.1 +/- 1.6 vs 0.5 +/- 1.4 and 0.22 +/- 0.68 Vs 0.07 +/- 0.29, respectively; P =.01 and P =.04), but there was no significant difference in the total number of adenomas per patient (primary end point) detected between the HRC and the SC groups (0.6 +/- 1.0 vs 0.5 +/- 0.9, respectively). Conclusions: Although HRC improves detection of purely flat adenomas and hyperplastic polyps, the overall detection of colonic adenomas in a population at increased risk of neoplasia is not significantly improved. These findings do not support the routine use of HRC in clinical practice.
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页码:349 / 354
页数:6
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