Chromoendoscopy or white light endoscopy for neoplasia detection in Lynch syndrome,a meta-analysis |
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Authors: | Ofir Har-Noy Diana E Yung Anastasios Koulaouzidis Rami Eliakim Uri Kopylov Benjamin Avidan Lior H Katz |
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Institution: | 1. Gastroenterology Department, Sheba Medical Center, Ramat-Gan, Israel;2. Department of Medicine A, Sheba Medical Center, Ramat-Gan, Israel;3. Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom;4. Sackler Faculty of Medicine, Tel-Aviv University, Israel |
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Abstract: | BackgroundLynch syndrome carries an increased risk of colorectal neoplasia, hence annual surveillance colonoscopy is recommended. This study aimed to compare the diagnostic yields of image enhancement modalities for colorectal neoplasia in patients with Lynch syndrome.MethodsMeta-analysis of pooled ratios of lesion detection rates (RRs) and odds ratios (ORs) with 95% confidence intervals (CIS), comparing white light endoscopy (WLE) and chromoendoscopy (ChE).ResultsFour studies comparing WLE to ChE were analyzed. ChE fared better than WLE in overall lesion detection (RR 1.97, 95% CI 1.63–2.38) and detection of adenomas (RR 1.53, 95% CI 1.07–2.17), flat lesions (RR 3.4, 95% CI 2.47–4.67) and proximally-located lesions (RR 2.93, 95% CI 1.91–4.5). The odds of a patient having any lesion found were higher in ChE compared to WLE (OR 2.42, 95% CI 1.56–3.75). The odds of a patient having adenoma(s) found on endoscopy were not significantly higher in chromoendoscopy compared to white light endoscopy (OR 1.81, 95% CI 0.65–5.01).ConclusionUsing standard definition technology, ChE allows detection of more lesions, especially adenomas, flat lesions and proximal lesions in Lynch syndrome patients, compared to WLE. The results show that surveillance colonoscopy of Lynch syndrome patients should be performed using ChE. |
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Keywords: | Corresponding author at: Gastroenterology Department Sheba Medical Center Ramat-Gan 5265601 Israel Chromoendoscopy Colonoscopy Hereditary non-polyposis colorectal cancer Lynch syndrome Meta-Analyses Surveillance |
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