Serhiy Semenov, Mohd Syafiq Ismail, Sandeep Sihag, Thilagaraj Manoharan, Phyllis Reilly, Gerard Boran, Barbara Ryan, Niall Breslin, Anthony O'Connor, Sarah O'Donnell, Deirdre McNamara
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CCE and endoscopy results, FIT accuracy and patient preference were assessed.</p><p><strong>Results: </strong>From a total of 126 CCEs [mean age 64 (31-80), 67 (53.2%) males), 70.6% (89/126) were excreted, 86.5% (109/126) had adequate image quality. CCE positivity was 70.6% (89/126), 42.9% (54/126) having significant polyps with 63.5% (80/126) referred for endoscopy (19 sigmoidoscopies, 61 colonoscopies). CCE reduced endoscopy need by 36.5% (46/126) and 51.6% (65/126) were spared a colonoscopy. CCE positive predictive value was 88.2% (45/51). Significant extracolonic findings were reported in 3.2% (4/126). Patients with positive CCEs were older > 65 [odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.1517-5.5787, <i>P</i> = 0.0159], with personal history of polyps (OR = 2.3, 95%CI: 0.9734-5.4066, <i>P</i> = 0.045), with high/intermediate polyp surveillance risk (OR = 5.4, 95%CI: 1.1979-24.3824, <i>P</i> = 0.0156). Overall, 5/114 (4.4%) FITs were positive (range: 0-1394 ng/mL, mean: 54 ng/mL). Sensitivity (9.6%) and negative predictive values (20.3%) were inadequate. Receiver operating curve analysis gave a sensitivity and specificity of 26.9% and 91.7%, for FIT of 43 ng/mL. Patients preferred CCE 63.3% (76/120), with less impact on daily activities (21.7% <i>vs</i> 93.2%) and time off work (average days 0.9 <i>vs</i> 1.2, <i>P</i> = 0.0201).</p><p><strong>Conclusion: </strong>CCE appears effective in low-risk polyp surveillance. FIT does not appear to be of benefit in surveillance.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 5","pages":"101322"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110150/pdf/","citationCount":"0","resultStr":"{\"title\":\"Colon capsule endoscopy is an effective filter test for colonic polyp surveillance.\",\"authors\":\"Serhiy Semenov, Mohd Syafiq Ismail, Sandeep Sihag, Thilagaraj Manoharan, Phyllis Reilly, Gerard Boran, Barbara Ryan, Niall Breslin, Anthony O'Connor, Sarah O'Donnell, Deirdre McNamara\",\"doi\":\"10.4253/wjge.v17.i5.101322\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Surveillance colonoscopies are predominantly normal, identifying patients for potential polypectomy is advantageous.</p><p><strong>Aim: </strong>To assess colon capsule endoscopy (CCE) and/or faecal immunochemical test (FIT) as filters in surveillance.</p><p><strong>Methods: </strong>Patients aged ≥ 18 due for polyp surveillance were invited for CCE and FIT. Identifying polyps or colorectal cancer resulted in a positive CCE. Significant lesions (≥ 3 polyps or ≥ 6 mm polyps), incomplete studies and positive FITs (≥ 225 ng/mL) were referred for endoscopy. CCE and endoscopy results, FIT accuracy and patient preference were assessed.</p><p><strong>Results: </strong>From a total of 126 CCEs [mean age 64 (31-80), 67 (53.2%) males), 70.6% (89/126) were excreted, 86.5% (109/126) had adequate image quality. CCE positivity was 70.6% (89/126), 42.9% (54/126) having significant polyps with 63.5% (80/126) referred for endoscopy (19 sigmoidoscopies, 61 colonoscopies). CCE reduced endoscopy need by 36.5% (46/126) and 51.6% (65/126) were spared a colonoscopy. CCE positive predictive value was 88.2% (45/51). Significant extracolonic findings were reported in 3.2% (4/126). Patients with positive CCEs were older > 65 [odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.1517-5.5787, <i>P</i> = 0.0159], with personal history of polyps (OR = 2.3, 95%CI: 0.9734-5.4066, <i>P</i> = 0.045), with high/intermediate polyp surveillance risk (OR = 5.4, 95%CI: 1.1979-24.3824, <i>P</i> = 0.0156). Overall, 5/114 (4.4%) FITs were positive (range: 0-1394 ng/mL, mean: 54 ng/mL). Sensitivity (9.6%) and negative predictive values (20.3%) were inadequate. Receiver operating curve analysis gave a sensitivity and specificity of 26.9% and 91.7%, for FIT of 43 ng/mL. Patients preferred CCE 63.3% (76/120), with less impact on daily activities (21.7% <i>vs</i> 93.2%) and time off work (average days 0.9 <i>vs</i> 1.2, <i>P</i> = 0.0201).</p><p><strong>Conclusion: </strong>CCE appears effective in low-risk polyp surveillance. FIT does not appear to be of benefit in surveillance.</p>\",\"PeriodicalId\":23953,\"journal\":{\"name\":\"World Journal of Gastrointestinal Endoscopy\",\"volume\":\"17 5\",\"pages\":\"101322\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110150/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Endoscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4253/wjge.v17.i5.101322\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Endoscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4253/wjge.v17.i5.101322","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：监测结肠镜检查主要是正常的，识别潜在息肉切除术的患者是有利的。目的：评价结肠胶囊内窥镜（CCE）和/或粪便免疫化学试验（FIT）在监测中的过滤作用。方法：邀请年龄≥18岁的息肉监测患者进行CCE和FIT检查。发现息肉或结直肠癌导致CCE阳性。重大病变（≥3个息肉或≥6mm息肉）、研究不完整和FITs阳性（≥225 ng/mL）均转至内镜检查。评估CCE和内窥镜检查结果、FIT准确性和患者偏好。结果：126例CCEs(平均年龄64岁（31 ~ 80岁），男性67例（53.2%），70.6%（89/126）排出体外，86.5%（109/126）影像质量良好。CCE阳性占70.6%(89/126)，有明显息肉者占42.9%(54/126)，其中63.5%（80/126）行内镜检查（乙状结肠镜19例，结肠镜61例）。CCE减少了36.5%（46/126）的内镜检查需求，51.6%（65/126）的患者无需结肠镜检查。CCE阳性预测值为88.2%（45/51）。3.2%（4/126）报告了显著的结肠外发现。CCEs阳性患者年龄≥65岁[比值比(OR) = 2.5, 95%可信区间（CI）： 1.1517 ~ 5.5787, P = 0.0159]，有息肉个人病史（OR = 2.3, 95%CI: 0.9734 ~ 5.4066, P = 0.045），有高/中息肉监测风险（OR = 5.4, 95%CI: 1.1979 ~ 24.3824, P = 0.0156）。总体而言，5/114 (4.4%)FITs呈阳性（范围：0-1394 ng/mL，平均值：54 ng/mL）。敏感性（9.6%）和阴性预测值（20.3%）不足。在FIT为43 ng/mL时，受试者工作曲线分析的灵敏度和特异度分别为26.9%和91.7%。患者偏好CCE 63.3%(76/120)，对日常活动（21.7% vs 93.2%）和休息时间（平均天数0.9 vs 1.2, P = 0.0201）的影响较小。结论：CCE在低风险息肉监测中是有效的。FIT似乎对监测没有好处。
Colon capsule endoscopy is an effective filter test for colonic polyp surveillance.
Background: Surveillance colonoscopies are predominantly normal, identifying patients for potential polypectomy is advantageous.
Aim: To assess colon capsule endoscopy (CCE) and/or faecal immunochemical test (FIT) as filters in surveillance.
Methods: Patients aged ≥ 18 due for polyp surveillance were invited for CCE and FIT. Identifying polyps or colorectal cancer resulted in a positive CCE. Significant lesions (≥ 3 polyps or ≥ 6 mm polyps), incomplete studies and positive FITs (≥ 225 ng/mL) were referred for endoscopy. CCE and endoscopy results, FIT accuracy and patient preference were assessed.
Results: From a total of 126 CCEs [mean age 64 (31-80), 67 (53.2%) males), 70.6% (89/126) were excreted, 86.5% (109/126) had adequate image quality. CCE positivity was 70.6% (89/126), 42.9% (54/126) having significant polyps with 63.5% (80/126) referred for endoscopy (19 sigmoidoscopies, 61 colonoscopies). CCE reduced endoscopy need by 36.5% (46/126) and 51.6% (65/126) were spared a colonoscopy. CCE positive predictive value was 88.2% (45/51). Significant extracolonic findings were reported in 3.2% (4/126). Patients with positive CCEs were older > 65 [odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.1517-5.5787, P = 0.0159], with personal history of polyps (OR = 2.3, 95%CI: 0.9734-5.4066, P = 0.045), with high/intermediate polyp surveillance risk (OR = 5.4, 95%CI: 1.1979-24.3824, P = 0.0156). Overall, 5/114 (4.4%) FITs were positive (range: 0-1394 ng/mL, mean: 54 ng/mL). Sensitivity (9.6%) and negative predictive values (20.3%) were inadequate. Receiver operating curve analysis gave a sensitivity and specificity of 26.9% and 91.7%, for FIT of 43 ng/mL. Patients preferred CCE 63.3% (76/120), with less impact on daily activities (21.7% vs 93.2%) and time off work (average days 0.9 vs 1.2, P = 0.0201).
Conclusion: CCE appears effective in low-risk polyp surveillance. FIT does not appear to be of benefit in surveillance.
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