Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1784654992026632192 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8862075 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT houwenbrittbsl linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT hazewinkelyark linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT pellisemaria linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT riverosanchezliseth linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT balaguerfrancesc linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT bisschopsraf linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT tejparsabine linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT repicialessandro linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT ramsoekhd linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT jacobsmaartenajm linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT schreuderramonmichelm linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT kaminskimichalfilip linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT rupinskamaria linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT bhandaripradeep linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT vanoijenmartijngh linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT koenslianne linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT bastiaansenbarbaraaj linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT tytgatkristienm linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT fockenspaul linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT vleugelsjasperla linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial AT dekkere linkedcolourimagingforthedetectionofpolypsinpatientswithlynchsyndromeamulticentreparallelrandomisedcontrolledtrial |