Colorectal Sessile Serrated Lesion Detection Using Linked Color Imaging: A Multicenter, Parallel Randomized Controlled Trial.

BACKGROUND & AIMS: Linked color imaging (LCI) is a novel technology that improves the color differences between colorectal lesions and the surrounding mucosa. The present study aims to compare the detection of colorectal sessile serrated lesions (SSL) using LCI with white light imaging (WLI). METHOD: A large-scale, multicenter, parallel prospective randomized controlled trial was conducted in 4 hospitals in China. The participants were randomly assigned to the LCI group and WLI group. The primary endpoint was the SSL detection rate (SDR). RESULTS: A total of 884 patients were involved in the intention-to-treat analysis, with 441 patients in the LCI group and 443 patients in the WLI group. The total polyp detection rate, adenoma detection rate, and SDR were 51.8%, 35.7%, and 8.6%, respectively. The SDR was significantly higher in the LCI group than in the WLI group (11.3% vs 5.9%, P = .004). Furthermore, LCI significantly increased the number of polyps and adenomas detected per patient, when compared with WLI (P < .05). In addition, there was higher detection rate of diminutive and flat lesions in the LCI group (P < .05). Multivariate analysis revealed that LCI is an independent factor associated with SDR (hazard ratio, 1.990; 95% confidence interval, 1.203-3.293; P = .007), along with withdrawal time (hazard ratio, 1.157; 95% confidence interval, 1.060-1.263; P = .001) and operator experience (hazard ratio, 1.850; 95% confidence interval, 1.045-3.273; P = .035). CONCLUSIONS: LCI is significantly superior to WLI for SSL detection, and may improve polyp and adenoma detection. LCI can be recommended as an appropriate method for routine inspection during colonoscopy (http://www.chictr.org.cn number, ChiCTR2000035705).

Colorectal sessile serrated lesion detection using linked-color imaging versus narrow-band imaging: a parallel randomized controlled trial.

BACKGROUND: Previous studies have reported the effectiveness of narrow-band imaging (NBI) and linked-color imaging (LCI) in improving the detection of colorectal neoplasms. There has however been no direct comparison between LCI and NBI in the detection of colorectal sessile serrated lesions (SSLs). The present study aimed to compare the effectiveness of LCI and NBI in detecting colorectal SSLs. METHODS: A prospective, parallel, randomized controlled trial was conducted. The participants were randomly assigned to the LCI or NBI arms. The primary end point was the SSL detection rate (SDR). RESULTS: 406 patients were involved; 204 in the LCI arm and 202 in the NBI arm. The total polyp detection rate, adenoma detection rate, and SDR were 54.2 %, 38.7 %, and 10.8%, respectively. The SDR was not significantly different between the LCI and NBI arms (12.3 % vs. 9.4 %; P = 0.36). The differences in the detection rate and the per-patient number of polyps, adenomas, diminutive lesions, and flat lesions between LCI and NBI also were not statistically significant. Multivariate analysis showed that LCI and NBI were not independent factors associated with SDR, whereas Boston Bowel Preparation Scale score (odds ratio [OR] 1.35, 95 %CI 1.03-1.76; P = 0.03), withdrawal time (OR 1.13, 95 %CI 1.00-1.26; P = 0.04), and operator experience (OR 3.73, 95 %CI 1.67-8.32; P = 0.001) were independent factors associated with SDR. CONCLUSIONS: LCI and NBI are comparable for SSL detection, as well as for the detection of polyps and adenomas.

Circulating Hepatocellular Cells are a Bad Prognostic Factor for HCC Patients.

BACKGROUND/AIMS: Circulating hepatocellular carcinoma cells (CHCCs) may be detected by reverse transcription-polymerase chain reaction (RT-PCR). We investigated the relationship between CHCCs and hepatoma patients' survival period after different managements. METHODOLOGY: Peripheral blood (5 ml) samples were obtained from 93 patients with hepatocellular carcinoma (HCC), and from 33 control subjects (9 with liver cirrhosis after hepatitis B, 14 with chronic hepatitis B, 10 with healthy people) between January 1st, 2009 and December 31, 2012. To detect CHCCs in peripheral blood, alpha-fetoprotein (AFP) messenger RNA (mRNA) was amplified from total RNA extracted from whole blood by RT-PCR. RESULTS: AFPmRNA was detected in 49 blood samples from the HCC patients (49/93, 53.0%). In contrast, there were no clinical control subjects whose samples showed detectable AFPmRNA. The presence of AFPmRNA in blood seemed to be correlated with the tumor stage (by TNM classification) of HCC, the serum AFP value, and the presence of intrahepatic metastasis, portal vein thrombosis, tumor diameter and/or distant metastasis. CONCLUSIONS: The presence of AFP mRNA in peripheral blood may be an indicator of CHCCs, which might predict hematogenous spreading metastasis in patients with HCC and may be as a bad prognostic factor for HCC patients.