Comparison of Image-Enhanced Endoscopy Techniques for Colorectal Lesion Detection and Characterization: A Network Meta-Analysis of Randomized Controlled Trials.

This network meta-analysiscompared the detection and diagnostic performance of various IEE modalities for colorectal lesions.

这项网络荟萃分析比较了各种IEE模式在结直肠病变检测和诊断性能方面的表现。

Methods

We searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) up to May 31, 2025.

我们检索了PubMed、Embase和Cochrane图书馆，以获取截至2025年5月31日的随机对照试验(RCTs)。

Primary outcomes included adenoma (adenoma detection rate [ADR]) and advanced ADR; secondary outcomes included polyp (polyp detection rate), sessile serrated lesion detection rate, and mean number of colonic lesions detected per patient.

主要结果包括腺瘤（腺瘤检出率[ADR]）和高级ADR；次要结果包括息肉（息肉检出率）、无蒂锯齿状病变检出率以及每例患者检测到的结肠病变平均数量。

Surface Under the Cumulative Ranking Curve (SUCRA) and pairwise risk ratios (RRs) with 95% confidence intervals (CI) were used.

使用了累积排名曲线下面积（SUCRA）和成对风险比（RRs）及其95%置信区间（CI）。

Lesion characterization was evaluated by the summary receiver operating characteristic area under the curve (AUC).

通过总结接收者操作特征曲线下面积（AUC）评估了病变特征。

Results

In total, 54 RCTs with 28,663 participants were included.

总共纳入了54项随机对照试验，涉及28,663名参与者。

Regarding ADR, texture and color enhancement imaging (TXI) ranked highest (SUCRA: 88.4; RR: 1.48, 95% CI: 1.09-2.02), followed by linked color imaging (LCI) when compared with high-definition white light imaging (HD-WLI).

关于不良事件报告率（ADR），纹理和颜色增强成像（TXI）排名最高（SUCRA：88.4；相对风险 RR：1.48，95% 置信区间 CI：1.09-2.02），其次是链接颜色成像（LCI），与高清白光成像（HD-WLI）相比。

For advanced adenoma detection, both TXI (RR: 1.42) and LCI (RR: 1.23) showed superiority over HD-WLI.

在高级腺瘤检测方面，TXI（相对风险：1.42）和LCI（相对风险：1.23）均显示出优于高清白光成像（HD-WLI）的优势。

New-generation narrow band imaging (NBI) ranked highest for the number of adenomas detected (SUCRA: 82.3%), and LCI led in polyps (SUCRA: 88.4%).

新一代窄带成像（NBI）在检测腺瘤数量方面排名最高（SUCRA：82.3%），而LCI在息肉检测方面领先（SUCRA：88.4%）。

For lesion characterization, new-generation NBI (AUC: 0.880) and blue light imaging (AUC: 0.812) effectively distinguished adenomas from non-neoplastic lesions.

在病变特征描述方面，新一代窄带成像（AUC: 0.880）和蓝光成像（AUC: 0.812）能有效区分腺瘤与非肿瘤性病变。

However, this finding is based on a limited number of RCTs and should be interpreted cautiously.

然而，这一发现基于有限数量的随机对照试验（RCTs），应谨慎解释。

Discussion

Our findings indicate TXI and LCI may provide improved detection performance compared with conventional imaging.

我们的研究结果表明，与传统影像学相比，TXI和LCI可能提供了更好的检测性能。

Blue light imaging and new-generation NBI seem to enhance lesion characterization.

蓝光成像和新一代NBI似乎增强了病变特征的描述。

Further comparative studies are needed to guide optimal IEE modality selection for colorectal neoplasia.

需要进一步的比较研究来指导结直肠肿瘤的最佳内镜下切除术(IEE)方式选择。