There are limited clinical data regarding the additional yields of random biopsies (RBs) during colorectal cancer surveillance in patients with inflammatory bowel disease. To assess the additional yield of RB, a systematic review and meta-analysis was conducted. PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies investigating the preferred colonoscopy surveillance approach for inflammatory bowel disease patients. The additional yield, detection rate, procedure time, and withdrawal time were pooled. Thirty-seven studies (48 arms) were included in the meta-analysis with 9051 patients. The additional yields of RB were 10.34% in per-patient analysis and 16.20% in per-lesion analysis. The detection rates were 1.31% and 2.82% in per-patient and per-lesion analysis, respectively. Subgroup analysis showed a decline in additional yields from 14.43% to 0.42% in the per-patient analysis and from 19.20% to 5.32% in the per-lesion analysis for studies initiated before and after 2011. In per-patient analysis, the additional yields were 4.83%, 10.29%, and 56.05% for primary sclerosing cholangitis (PSC) proportions of 0% to 10%, 10% to 30%, and 100%, respectively. The corresponding detection rates were 0.56%, 1.40%, and 19.45%. In the per-lesion analysis, additional yields were 11.23%, 21.06%, and 45.22% for PSC proportions of 0% to 10%, 10% to 30%, and 100%, respectively. The corresponding detection rates were 2.09%, 3.58%, and 16.24%. The additional yields of RB were 10.34% and 16.20% for per-patient and per-lesion analyses, respectively. Considering the decreased additional yields in studies initiated after 2011, and the influence of PSC, endoscopy centers lacking full high-definition equipment should consider incorporating RB in the standard colonoscopy surveillance for inflammatory bowel disease patients, especially in those with PSC.

中文翻译：

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炎症性肠病患者随机活检的额外产量：系统评价和荟萃分析


关于炎症性肠病患者结直肠癌监测期间随机活检 (RB) 额外产量的临床数据有限。为了评估 RB 的额外产量，进行了系统评价和荟萃分析。检索了 PubMed、Embase、Web of Science 和 Cochrane 图书馆，以查找调查炎症性肠病患者首选结肠镜检查监测方法的研究。汇总额外产量、检测率、手术时间和退出时间。荟萃分析中纳入了 37 项研究（48 组），涉及 9051 名患者。每个患者分析中 RB 的额外产量为 10.34%，每个病灶分析中的 RB 额外产量为 16.20%。每个患者和每个病灶分析的检出率分别为 1.31% 和 2.82%。亚组分析显示，对于 2011 年前后启动的研究，每名患者分析的额外产量从 14.43% 下降至 0.42%，每病灶分析从 19.20% 下降至 5.32%。在每名患者分析中，额外产量下降原发性硬化性胆管炎 (PSC) 比例为 0% 至 10%、10% 至 30% 和 100% 的比例分别为 4.83%、10.29% 和 56.05%。相应的检出率分别为0.56%、1.40%、19.45%。在每个病灶分析中，PSC 比例为 0% 至 10%、10% 至 30% 和 100% 时，额外产量分别为 11.23%、21.06% 和 45.22%。相应的检出率分别为2.09%、3.58%、16.24%。对于每个患者和每个病变分析，RB 的额外产量分别为 10.34% 和 16.20%。 考虑到2011年以后启动的研究的额外产量下降以及PSC的影响，缺乏全高清设备的内镜中心应考虑将RB纳入炎症性肠病患者，特别是PSC患者的标准结肠镜监测中。