Ofir Har-Noy1,2, Lior Katz3,4, Tomer Avni4,5, Robert Battat6, Talat Bessissow6, Diana E Yung7, Tal Engel3, Anastasios Koulaouzidis7, Rami Eliakim3,4, Shomron Ben-Horin3,4, Uri Kopylov3,4. 1. Gastroenterology Department, Sheba Medical Center, Ramat Gan, Israel. ofirharnoy@gmail.com. 2. Department of Medicine A, Sheba Medical Center, Ramat Gan, Israel. ofirharnoy@gmail.com. 3. Gastroenterology Department, Sheba Medical Center, Ramat Gan, Israel. 4. Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. 5. Department of Medicine E, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 6. Division of Gastroenterology, McGill University Health Center, Montréal, QC, Canada. 7. Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, UK.
Abstract
BACKGROUND: Studies have confirmed an increased risk of colorectal cancer in patients with ulcerative colitis; hence, surveillance is recommended. Optional modalities include white light endoscopy (WLE) or dye-spray chromoendoscopy. However, narrow-band imaging (NBI) is still not considered comparable to chromoendoscopy. AIM: The aim of this study was to compare the diagnostic yield (DY) of WLE, chromoendoscopy, NBI for detection of neoplasia in patients with inflammatory bowel disease (IBD) by performing a meta-analysis of the existing literature. METHODS: We searched databases for prospective studies. For each modality, we performed comparative per-lesion analysis (any neoplasia detection) and per-patient analysis (patient with neoplastic lesions). Meta-analysis was performed using fixed-effect model unless heterogeneity was high. Odds ratios (ORs) with 95% CIs were calculated and pooled. RESULTS: Five studies compared chromoendoscopy to WLE. Chromoendoscopy (n = 361) was superior to WLE (n = 358) with per-patient analysis OR 2.05 (95% CI 1.26, 3.35) and per-lesion analysis OR 2.79 (95% CI 2.08, 3.73). High-definition (HD) chromoendoscopy was superior to HD-WLE with per-lesion analysis OR 2.48 (95% CI 1.55, 3.97). In four studies comparing NBI to WLE (n = 305), no difference was found in per-patient analysis OR 0.97 (95% CI 0.62, 1.53) and per-lesion analysis OR 0.94 (95% CI 0.63, 1.4). In two studies comparing CE to NBI (n = 104), no difference was found in per-patient analysis OR 1.0 (95% CI 0.51, 1.95) and per-lesion analysis OR 1.29 (95% CI 0.69, 2.41). CONCLUSION: Chromoendoscopy is superior to WLE for detection of dysplasia in IBD, even with HD endoscopy. No difference in DY could be demonstrated for NBI in comparison with other modalities.
BACKGROUND: Studies have confirmed an increased risk of colorectal cancer in patients with ulcerative colitis; hence, surveillance is recommended. Optional modalities include white light endoscopy (WLE) or dye-spray chromoendoscopy. However, narrow-band imaging (NBI) is still not considered comparable to chromoendoscopy. AIM: The aim of this study was to compare the diagnostic yield (DY) of WLE, chromoendoscopy, NBI for detection of neoplasia in patients with inflammatory bowel disease (IBD) by performing a meta-analysis of the existing literature. METHODS: We searched databases for prospective studies. For each modality, we performed comparative per-lesion analysis (any neoplasia detection) and per-patient analysis (patient with neoplastic lesions). Meta-analysis was performed using fixed-effect model unless heterogeneity was high. Odds ratios (ORs) with 95% CIs were calculated and pooled. RESULTS: Five studies compared chromoendoscopy to WLE. Chromoendoscopy (n = 361) was superior to WLE (n = 358) with per-patient analysis OR 2.05 (95% CI 1.26, 3.35) and per-lesion analysis OR 2.79 (95% CI 2.08, 3.73). High-definition (HD) chromoendoscopy was superior to HD-WLE with per-lesion analysis OR 2.48 (95% CI 1.55, 3.97). In four studies comparing NBI to WLE (n = 305), no difference was found in per-patient analysis OR 0.97 (95% CI 0.62, 1.53) and per-lesion analysis OR 0.94 (95% CI 0.63, 1.4). In two studies comparing CE to NBI (n = 104), no difference was found in per-patient analysis OR 1.0 (95% CI 0.51, 1.95) and per-lesion analysis OR 1.29 (95% CI 0.69, 2.41). CONCLUSION: Chromoendoscopy is superior to WLE for detection of dysplasia in IBD, even with HD endoscopy. No difference in DY could be demonstrated for NBI in comparison with other modalities.
Authors: Gauree Gupta Konijeti; Mark G Shrime; Ashwin N Ananthakrishnan; Andrew T Chan Journal: Gastrointest Endosc Date: 2013-11-18 Impact factor: 9.427
Authors: Andrea Iannone; Marinella Ruospo; Germaine Wong; Mariabeatrice Principi; Michele Barone; Giovanni F M Strippoli; Alfredo Di Leo Journal: Clin Gastroenterol Hepatol Date: 2016-11-25 Impact factor: 11.382
Authors: Choon Jin Ooi; Kwong Ming Fock; Govind K Makharia; Khean Lee Goh; Khoon Lin Ling; Ida Hilmi; Wee Chian Lim; Thia Kelvin; Peter R Gibson; Richard B Gearry; Qin Ouyang; Jose Sollano; Sathaporn Manatsathit; Rungsun Rerknimitr; Shu-Chen Wei; Wai Keung Leung; H Janaka de Silva; Rupert Wl Leong Journal: J Gastroenterol Hepatol Date: 2010-03 Impact factor: 4.029
Authors: Ludger Leifeld; Gerhard Rogler; Andreas Stallmach; Carsten Schmidt; Ina Zuber-Jerger; Franz Hartmann; Mathias Plauth; Attyla Drabik; Ferdinand Hofstädter; Hans Peter Dienes; Wolfgang Kruis Journal: Clin Gastroenterol Hepatol Date: 2015-05-05 Impact factor: 11.382
Authors: James F Marion; Jerome D Waye; Daniel H Present; Yuriy Israel; Carol Bodian; Noam Harpaz; Mark Chapman; Steven Itzkowitz; Adam F Steinlauf; Maria T Abreu; Thomas A Ullman; James Aisenberg; Lloyd Mayer Journal: Am J Gastroenterol Date: 2008-09 Impact factor: 10.864
Authors: Constance M Johnson; Caimiao Wei; Joe E Ensor; Derek J Smolenski; Christopher I Amos; Bernard Levin; Donald A Berry Journal: Cancer Causes Control Date: 2013-04-06 Impact factor: 2.506
Authors: Penny F Whiting; Anne W S Rutjes; Marie E Westwood; Susan Mallett; Jonathan J Deeks; Johannes B Reitsma; Mariska M G Leeflang; Jonathan A C Sterne; Patrick M M Bossuyt Journal: Ann Intern Med Date: 2011-10-18 Impact factor: 25.391
Authors: Gerard Cummins; Benjamin F Cox; Gastone Ciuti; Thineskrishna Anbarasan; Marc P Y Desmulliez; Sandy Cochran; Robert Steele; John N Plevris; Anastasios Koulaouzidis Journal: Nat Rev Gastroenterol Hepatol Date: 2019-07 Impact factor: 46.802