Alternative Title大腸腫瘍性病変の拾い上げ診断における透明フードを併用した自家蛍光内視鏡の有用性:前向き無作為化比較試験
Periodical titleGastrointestinal endoscopy
Note (General)type:Thesis
BACKGROUND:Colonoscopy is one of the most reliable methods for detection of colorectal neoplasms, but conventional colonoscopy can miss some lesions.OBJECTIVE:To evaluate the efficacy of autofluorescence imaging (AFI) with a transparent hood (TH) for detection of colorectal neoplasms.DESIGN:A 2 × 2 factorial designed, prospective, randomized, controlled trial.SETTING:This study was conducted at the Osaka Medical Center for Cancer and Cardiovascular Diseases, a tertiary cancer center.PATIENTS:A total of 561 patients.INTERVENTIONS:Patients were allocated to 1 of 4 groups: (1) white light imaging (WLI) alone--colonoscopy using WLI without a TH; (2) WLI+TH--colonoscopy using WLI with a TH; (3) AFI alone--colonoscopy using AFI without a TH; and (4) AFI+TH--colonoscopy using AFI with a TH. Eight colonoscopists used each allocated method.MAIN OUTCOME MEASUREMENT:The difference in neoplasm detection rate (number of detected neoplasms per patient) between the WLI alone and AFI+TH groups.RESULTS:Neoplasm detection rate (95% confidence interval) in the AFI+TH group was significantly higher than in the WLI alone group (1.96 [1.50-2.43] vs 1.19 [0.93-1.44]; P = .023, Tukey-Kramer multiple comparison test). Relative detection ratios (95% confidence interval) for polypoid neoplasms based on Poisson regression model were significantly increased by mounting a TH (1.69 [1.34-2.12], P < .001), and relative detection ratios for flat neoplasms were significantly increased by AFI observation (1.83 [1.24-2.71], P = .002).LIMITATIONS:Open trial performed in single cancer referral center.CONCLUSION:AFI colonoscopy with a TH detected significantly more colorectal neoplasms than did conventional WLI colonoscopy without a TH.
博士(医学)・乙1327号・平成26年3月17日
identifier:Gastrointestinal endoscopy Vol.72 No.5 p.1006-1013
identifier:00165107
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/2712
identifier:Gastrointestinal endoscopy, 72(5): 1006-1013
DOIinfo:doi/10.1016/j.gie.2010.06.055
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2015-02-03T05:25:05+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション