炎症性肠病患者随机活检的额外收益：系统回顾和荟萃分析。
IF 11.6
1区 医学
Q1 GASTROENTEROLOGY & HEPATOLOGY
引用次数: 0
摘要
背景和目的：有关炎症性肠病患者结直肠癌监测期间随机活检的额外收益的临床数据十分有限。为了评估 RB 的额外收益，我们进行了一项系统回顾和荟萃分析：方法：检索了 PubMed、Embase、Web of Science 和 Cochrane 图书馆中有关 IBD 患者首选结肠镜监测方法的研究。对额外收益、检出率、手术时间和退出时间进行了汇总：荟萃分析纳入了 37 项研究（48 项研究），共 9051 名患者。按患者分析，RB 的额外收益率为 10.34%，按病灶分析，额外收益率为 16.20%。按患者和按病灶分析的检出率分别为 1.31% 和 2.82%。亚组分析显示，2011年之前和之后启动的研究的额外检出率分别从14.43%和19.20%下降到0.42%和5.32%。在按患者分析中，PSC比例为0-10%、10-30%和100%时，额外检出率分别为4.83%、10.29%和56.05%。相应的检出率分别为 0.56%、1.40% 和 19.45%。在每个裂隙分析中，当 PSC 比例为 0-10%、10-30% 和 100%时，额外产量分别为 11.23%、21.06% 和 45.22%。相应的检出率分别为 2.09%、3.58% 和 16.24%：对每个患者和每个病灶进行分析时，RB 的额外检出率分别为 10.34% 和 16.20%。考虑到 2011 年后开展的研究中额外检查率的下降以及 PSC 的影响，缺乏全高清设备的内镜中心应考虑将 RB 纳入 IBD 患者（尤其是 PSC 患者）的标准结肠镜检查监测中。本文章由计算机程序翻译，如有差异，请以英文原文为准。
Additional Yield of Random Biopsy in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Background
There are limited clinical data regarding the additional yields of random biopsies (RBs) during colorectal cancer surveillance in patients with inflammatory bowel disease. To assess the additional yield of RB, a systematic review and meta-analysis was conducted.
Methods
PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies investigating the preferred colonoscopy surveillance approach for inflammatory bowel disease patients. The additional yield, detection rate, procedure time, and withdrawal time were pooled.
Results
Thirty-seven studies (48 arms) were included in the meta-analysis with 9051 patients. The additional yields of RB were 10.34% in per-patient analysis and 16.20% in per-lesion analysis. The detection rates were 1.31% and 2.82% in per-patient and per-lesion analysis, respectively. Subgroup analysis showed a decline in additional yields from 14.43% to 0.42% in the per-patient analysis and from 19.20% to 5.32% in the per-lesion analysis for studies initiated before and after 2011. In per-patient analysis, the additional yields were 4.83%, 10.29%, and 56.05% for primary sclerosing cholangitis (PSC) proportions of 0% to 10%, 10% to 30%, and 100%, respectively. The corresponding detection rates were 0.56%, 1.40%, and 19.45%. In the per-lesion analysis, additional yields were 11.23%, 21.06%, and 45.22% for PSC proportions of 0% to 10%, 10% to 30%, and 100%, respectively. The corresponding detection rates were 2.09%, 3.58%, and 16.24%.
Conclusions
The additional yields of RB were 10.34% and 16.20% for per-patient and per-lesion analyses, respectively. Considering the decreased additional yields in studies initiated after 2011, and the influence of PSC, endoscopy centers lacking full high-definition equipment should consider incorporating RB in the standard colonoscopy surveillance for inflammatory bowel disease patients, especially in those with PSC.
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍：
Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion.
As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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