Background Miss rate of colorectal neoplasia is associated with lesion histology, size, morphology, or location. Objectives We aim to compare the efficacy of Linked color imaging (LCI) versus white light imaging (WLI) for adenoma detection rate (ADR), the detection of sessile serrated lesions (SSLs), serrated lesions (SLs), advanced adenomas (AAs), diminutive lesions (DLs), and flat lesions (FLs) by using per-patient and per-lesion analysis based on randomized controlled trials (RCTs). Design Systematic review and meta-analysis. Data sources and methods PubMed, Embase, and Cochrane databases were searched through May 1st, 2023. We calculated risk ratio for dichotomous outcomes and mean difference for continuous outcomes, and performed sensitivity analyses and subgroup analyses. Results Overall, 17 RCTs (10,624 patients) were included. In per-patient analysis, ADR was higher in the LCI group versus the WLI group (p < 0.00001). This effect was consistent for SSL (p = 0.005), SLs (p = 0.01), AAs (p = 0.04), DLs (p < 0.00001), and FLs (p < 0.0001). In per-lesion analysis, LCI showed a significant superiority over WLI with regard to the mean number of adenomas per patient (p < 0.00001). This effect was in accordance with mean SSL (p = 0.001), mean SLs (p < 0.00001), and mean DLs (p < 0.0001) per patient. A subgroup analysis showed that the beneficial effect of the LCI group on the detection of AAs, SSL, and FLs was maintained only for studies when experts and trainees were included but not for experts only. Conclusions Meta-analyses of RCTs data support the use of LCI in clinical practice, especially for trainees.

中文翻译：

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链接彩色成像与白光成像在结直肠病变诊断中的比较：随机对照试验的荟萃分析。

背景 结直肠肿瘤的漏诊率与病变组织学、大小、形态或位置相关。目的 我们的目的是比较连锁彩色成像 (LCI) 与白光成像 (WLI) 在腺瘤检出率 (ADR)、无蒂锯齿状病变 (SSL)、锯齿状病变 (SL)、晚期腺瘤 (AA) 检测方面的功效通过使用基于随机对照试验 (RCT) 的每位患者和每个病灶分析来识别小型病灶 (DL) 和扁平病灶 (FL)。设计系统回顾和荟萃分析。数据来源和方法 PubMed、Embase 和 Cochrane 数据库检索截至 2023 年 5 月 1 日。我们计算了二分结果的风险比和连续结果的平均差，并进行了敏感性分析和亚组分析。结果 总体而言，纳入了 17 项随机对照试验（10,624 名患者）。在每名患者的分析中，LCI 组的 ADR 高于 WLI 组 (p < 0.00001)。对于 SSL (p = 0.005)、SL (p = 0.01)、AA (p = 0.04)、DL (p < 0.00001) 和 FL (p < 0.0001)，这种效果是一致的。在每个病灶分析中，就每位患者的平均腺瘤数量而言，LCI 显着优于 WLI (p < 0.00001)。该效果与每位患者的平均 SSL (p = 0.001)、平均 SL (p < 0.00001) 和平均 DL (p < 0.0001) 一致。亚组分析表明，LCI 组对 AA、SSL 和 FL 检测的有益效果仅在包含专家和受训人员的研究中得以维持，而不仅仅针对专家。结论 RCT 数据的荟萃分析支持 LCI 在临床实践中的使用，特别是对于学员而言。