在Helicobacter pylori-naïve患者中,卵性胃腺瘤和胃超塑性息肉之间进行内镜差异诊断
Kotaro Shibagaki1, Norihisa Ishimura2, Satoshi Kotani2
1Department of Endoscopy, Shimane University Hospital, 89-1 Enya, Izumo, Shimane, 693-8501, Japan. kotaro@med.shimane-u.ac.jp.
概括
一个新的内镜诊断指数准确地区分了先前没有感染过Helicobacter pylori的个体的型胃腺瘤 (FGA) 与胃高增殖性息肉. 这个指数可以改善手术前诊断和患者管理.
科学领域:
- 胃肠病学 胃肠病学
- 内镜诊断的诊断方法
- 在瘤学瘤学.
背景情况:
- 状型胃腺瘤 (FGA) 在未接触过H. pylori的个体中类似于Helicobacter pylori-naïve胃增生息肉 (HpN-GHP).
- 将FGA与HPN-GHP区分开来是具有挑战性的,原因是低度组织学异位,复杂化了基于活检的诊断.
研究的目的:
- 开发一个内镜诊断指数,以区分FGA和HPN-GHP.
- 为了提高这两种胃病变之间的手术前差异诊断的准确性.
主要方法:
- 使用白光内镜 (WLE) 和用放大内镜 (NBIME) 进行狭带成像,对51个FGA和36个HPN-GHP进行了回顾性分析.
- 由专家和非专家评估病变特征,将内镜检查结果与组织学相关联.
- 基于关键内镜标准的复合诊断指数的开发和验证.
主要成果:
- FGA表现出明显的特征:明亮的红色 (94.1%),外围增生 (58.8%),乳头/状的微观结构 (96.1%),可见的毛细血管 (70.6%) 和分界线 (98.0%).
- 常见的HPN-GHPs显示白色区域变厚 (52.8%).
- 结合四个标准的诊断指数获得了FGA的90.2%的灵敏度和94.4%的特异性,观察者之间有很好的一致性 (kappa ≥0.6).
结论:
- 一个复合诊断指数使得FGA和HPN-GHP的可重复和准确的手术前分化.
- 这种内镜工具有助于区分这些病变,潜在地改善患者管理,减少不必要的干预.
更多相关视频
05:23Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
423
03:47Retinal and Choroidal Thickness Changes in Populations with Helicobacter pylori Infection by Swept-Source Optical Coherence Tomography
Published on: November 1, 2024
236
相关概念视频
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
157
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
157
01:30Peptic Ulcer Disease I: Introduction
199
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
199
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
454
Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
454
01:27Gastritis-I: Introduction and Types
540
Gastritis, defined by the inflammation or irritation of the stomach lining or gastric mucosa, manifests in several distinct forms: acute, chronic, reactive, and a specific subtype known as autoimmune metaplastic atrophic gastritis.
Acute gastritis presents as a sudden inflammation triggered by various stressors to the stomach lining, such as exposure to corrosive agents, local irritants like aspirin and other NSAIDs, alcohol consumption, radiation therapy, physical trauma, severe burns, sepsis,...
Acute gastritis presents as a sudden inflammation triggered by various stressors to the stomach lining, such as exposure to corrosive agents, local irritants like aspirin and other NSAIDs, alcohol consumption, radiation therapy, physical trauma, severe burns, sepsis,...
540
01:17Gastritis-II: Pathophysiology
375
Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
375
01:23Gastritis III: Clinical Manifestations and Management
326
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
326