Chromoendoscopy or white light endoscopy for neoplasia detection in Lynch syndrome, a meta-analysis

Ofir Har-Noy, Diana E. Yung, Anastasios Koulaouzidis, Rami Eliakim, Uri Kopylov, Benjamin Avidan, Lior H. Katz

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Lynch syndrome carries an increased risk of colorectal neoplasia, hence annual surveillance colonoscopy is recommended. This study aimed to compare the diagnostic yields of image enhancement modalities for colorectal neoplasia in patients with Lynch syndrome. Methods: Meta-analysis of pooled ratios of lesion detection rates (RRs) and odds ratios (ORs) with 95% confidence intervals (CIS), comparing white light endoscopy (WLE) and chromoendoscopy (ChE). Results: Four studies comparing WLE to ChE were analyzed. ChE fared better than WLE in overall lesion detection (RR 1.97, 95% CI 1.63–2.38) and detection of adenomas (RR 1.53, 95% CI 1.07–2.17), flat lesions (RR 3.4, 95% CI 2.47–4.67) and proximally-located lesions (RR 2.93, 95% CI 1.91–4.5). The odds of a patient having any lesion found were higher in ChE compared to WLE (OR 2.42, 95% CI 1.56–3.75). The odds of a patient having adenoma(s) found on endoscopy were not significantly higher in chromoendoscopy compared to white light endoscopy (OR 1.81, 95% CI 0.65–5.01). Conclusion: Using standard definition technology, ChE allows detection of more lesions, especially adenomas, flat lesions and proximal lesions in Lynch syndrome patients, compared to WLE. The results show that surveillance colonoscopy of Lynch syndrome patients should be performed using ChE.

Original languageEnglish
Pages (from-to)1515-1521
Number of pages7
JournalDigestive and Liver Disease
Volume51
Issue number11
DOIs
StatePublished - Nov 2019

Keywords

  • Chromoendoscopy
  • Colonoscopy
  • Hereditary non-polyposis colorectal cancer
  • Lynch syndrome
  • Meta-Analyses
  • Surveillance

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