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Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial

OBJECTIVE: Despite regular colonoscopy surveillance, colorectal cancers still occur in patients with Lynch syndrome. Thus, detection of all relevant precancerous lesions remains very important. The present study investigates Linked Colour imaging (LCI), an image-enhancing technique, as compared with...

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Autores principales: Houwen, Britt B S L, Hazewinkel, Yark, Pellisé, María, Rivero-Sánchez, Liseth, Balaguer, Francesc, Bisschops, Raf, Tejpar, Sabine, Repici, Alessandro, Ramsoekh, D, Jacobs, Maarten A J M, Schreuder, Ramon-Michel M, Kaminski, Michal Filip, Rupinska, Maria, Bhandari, Pradeep, van Oijen, Martijn G H, Koens, Lianne, Bastiaansen, Barbara A J, Tytgat, Kristien M, Fockens, Paul, Vleugels, Jasper L A, Dekker, E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8862075/
https://www.ncbi.nlm.nih.gov/pubmed/34086597
http://dx.doi.org/10.1136/gutjnl-2020-323132
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author Houwen, Britt B S L
Hazewinkel, Yark
Pellisé, María
Rivero-Sánchez, Liseth
Balaguer, Francesc
Bisschops, Raf
Tejpar, Sabine
Repici, Alessandro
Ramsoekh, D
Jacobs, Maarten A J M
Schreuder, Ramon-Michel M
Kaminski, Michal Filip
Rupinska, Maria
Bhandari, Pradeep
van Oijen, Martijn G H
Koens, Lianne
Bastiaansen, Barbara A J
Tytgat, Kristien M
Fockens, Paul
Vleugels, Jasper L A
Dekker, E
author_facet Houwen, Britt B S L
Hazewinkel, Yark
Pellisé, María
Rivero-Sánchez, Liseth
Balaguer, Francesc
Bisschops, Raf
Tejpar, Sabine
Repici, Alessandro
Ramsoekh, D
Jacobs, Maarten A J M
Schreuder, Ramon-Michel M
Kaminski, Michal Filip
Rupinska, Maria
Bhandari, Pradeep
van Oijen, Martijn G H
Koens, Lianne
Bastiaansen, Barbara A J
Tytgat, Kristien M
Fockens, Paul
Vleugels, Jasper L A
Dekker, E
author_sort Houwen, Britt B S L
collection PubMed
description OBJECTIVE: Despite regular colonoscopy surveillance, colorectal cancers still occur in patients with Lynch syndrome. Thus, detection of all relevant precancerous lesions remains very important. The present study investigates Linked Colour imaging (LCI), an image-enhancing technique, as compared with high-definition white light endoscopy (HD-WLE) for the detection of polyps in this patient group. DESIGN: This prospective, randomised controlled trial was performed by 22 experienced endoscopists from eight centres in six countries. Consecutive Lynch syndrome patients ≥18 years undergoing surveillance colonoscopy were randomised (1:1) and stratified by centre for inspection with either LCI or HD-WLE. Primary outcome was the polyp detection rate (PDR). RESULTS: Between January 2018 and March 2020, 357 patients were randomised and 332 patients analysed (160 LCI, 172 HD-WLE; 6 excluded due to incomplete colonoscopies and 19 due to insufficient bowel cleanliness). No significant difference was observed in PDR with LCI (44.4%; 95% CI 36.5% to 52.4%) compared with HD-WLE (36.0%; 95% CI 28.9% to 43.7%) (p=0.12). Of the secondary outcome parameters, more adenomas were found on a patient (adenoma detection rate 36.3%; vs 25.6%; p=0.04) and a colonoscopy basis (mean adenomas per colonoscopy 0.65 vs 0.42; p=0.04). The median withdrawal time was not statistically different between LCI and HD-WLE (12 vs 11 min; p=0.16). CONCLUSION: LCI did not improve the PDR compared with HD-WLE in patients with Lynch syndrome undergoing surveillance. The relevance of findings more adenomas by LCI has to be examined further. TRIAL REGISTRATION NUMBER: NCT03344289.
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spelling pubmed-88620752022-03-15 Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial Houwen, Britt B S L Hazewinkel, Yark Pellisé, María Rivero-Sánchez, Liseth Balaguer, Francesc Bisschops, Raf Tejpar, Sabine Repici, Alessandro Ramsoekh, D Jacobs, Maarten A J M Schreuder, Ramon-Michel M Kaminski, Michal Filip Rupinska, Maria Bhandari, Pradeep van Oijen, Martijn G H Koens, Lianne Bastiaansen, Barbara A J Tytgat, Kristien M Fockens, Paul Vleugels, Jasper L A Dekker, E Gut Endoscopy OBJECTIVE: Despite regular colonoscopy surveillance, colorectal cancers still occur in patients with Lynch syndrome. Thus, detection of all relevant precancerous lesions remains very important. The present study investigates Linked Colour imaging (LCI), an image-enhancing technique, as compared with high-definition white light endoscopy (HD-WLE) for the detection of polyps in this patient group. DESIGN: This prospective, randomised controlled trial was performed by 22 experienced endoscopists from eight centres in six countries. Consecutive Lynch syndrome patients ≥18 years undergoing surveillance colonoscopy were randomised (1:1) and stratified by centre for inspection with either LCI or HD-WLE. Primary outcome was the polyp detection rate (PDR). RESULTS: Between January 2018 and March 2020, 357 patients were randomised and 332 patients analysed (160 LCI, 172 HD-WLE; 6 excluded due to incomplete colonoscopies and 19 due to insufficient bowel cleanliness). No significant difference was observed in PDR with LCI (44.4%; 95% CI 36.5% to 52.4%) compared with HD-WLE (36.0%; 95% CI 28.9% to 43.7%) (p=0.12). Of the secondary outcome parameters, more adenomas were found on a patient (adenoma detection rate 36.3%; vs 25.6%; p=0.04) and a colonoscopy basis (mean adenomas per colonoscopy 0.65 vs 0.42; p=0.04). The median withdrawal time was not statistically different between LCI and HD-WLE (12 vs 11 min; p=0.16). CONCLUSION: LCI did not improve the PDR compared with HD-WLE in patients with Lynch syndrome undergoing surveillance. The relevance of findings more adenomas by LCI has to be examined further. TRIAL REGISTRATION NUMBER: NCT03344289. BMJ Publishing Group 2022-03 2021-03-18 /pmc/articles/PMC8862075/ /pubmed/34086597 http://dx.doi.org/10.1136/gutjnl-2020-323132 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Endoscopy
Houwen, Britt B S L
Hazewinkel, Yark
Pellisé, María
Rivero-Sánchez, Liseth
Balaguer, Francesc
Bisschops, Raf
Tejpar, Sabine
Repici, Alessandro
Ramsoekh, D
Jacobs, Maarten A J M
Schreuder, Ramon-Michel M
Kaminski, Michal Filip
Rupinska, Maria
Bhandari, Pradeep
van Oijen, Martijn G H
Koens, Lianne
Bastiaansen, Barbara A J
Tytgat, Kristien M
Fockens, Paul
Vleugels, Jasper L A
Dekker, E
Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial
title Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial
title_full Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial
title_fullStr Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial
title_full_unstemmed Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial
title_short Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: a multicentre, parallel randomised controlled trial
title_sort linked colour imaging for the detection of polyps in patients with lynch syndrome: a multicentre, parallel randomised controlled trial
topic Endoscopy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8862075/
https://www.ncbi.nlm.nih.gov/pubmed/34086597
http://dx.doi.org/10.1136/gutjnl-2020-323132
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