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Systematic review with meta‐analysis: Chromoendoscopy versus white light endoscopy in detection of dysplasia in patients with inflammatory bowel disease
Author(s) -
Wan Jian,
Wang Xuan,
Yang Zhi Ping,
Wu Kai Chun
Publication year - 2019
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12714
Subject(s) - chromoendoscopy , medicine , dysplasia , inflammatory bowel disease , meta analysis , relative risk , magnification , colonoscopy , confidence interval , gastroenterology , colorectal cancer , disease , cancer , computer science , computer vision
Objective To compare chromoendoscopy (CE) and white light endoscopy (WLE) for dysplasia surveillance in patients with inflammatory bowel disease (IBD). Methods We conducted a meta‐analysis of 6 randomized controlled trials (RCTs) and 5 prospective studies and compared the CE and WLE groups. A fixed‐effect model was used unless the heterogeneity was high. Results CE detected more patients with dysplasia (relative risk [RR] 2.05, 95% confidence interval [CI]: 1.62‐2.61) and more dysplastic lesions (RR 2.04, 95% CI: 1.40‐2.98) than WLE. When magnification was added to CE, the detection rate of patients with dysplasia and dysplastic lesions improved. CE also detected more patients with dysplasia than high‐definition WLE (RR 1.60, 95% CI: 1.11‐2.29). Compared with WLE, the incremental yield of CE for detecting patients with dysplasia was 9%. CE was superior to WLE in detecting non‐polypoid dysplastic lesions (RR 1.38, 95% CI:1.02‐1.88). CE had no advantage for detecting polypoid dysplastic lesions compared with WLE. Conclusions CE is superior to WLE in the surveillance of dysplasia in IBD patients. It is thus necessary to use CE in the surveillance of dysplasia in patients with IBD in clinical practice. Adding magnification improves the detection rate.