组织系统病理学测试优于病理学审查,在低级失塑症的风险分层患者中
Amir M Khoshiwal1, Nicola F Frei1, Roos E Pouw2
1Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands.
Gastroenterology
|September 1, 2023
概括
一个新的组织测试 (TSP-9) 对于巴雷特食道的低度发育不良 (LGD) 显示在预测癌症进展方面比病理学家更高的准确性,改善风险分层,以获得更好的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 巴雷特食道 (BE) 与低度发育不良 (LGD) 携带瘤进展的风险增加.
- 由于病理学家之间有显著的观察者间变异性,对LGD的诊断受到挑战.
- 一个客观的组织测试,TSP-9,已经显示出预测瘤进展的承诺在BE.
研究的目的:
- 为了比较TSP-9测试的风险分层性能与通用学家和专家病理学审查.
- 评估TSP-9在预测LGD的BE患者中高度发育不良 (HGD) 和食道腺癌 (EAC) 的准确性.
主要方法:
- 一项盲目的队列研究,涉及154名患有BE和LGD的患者,来自随机对照试验.
- 活检用TSP-9测试进行评估,并由30名病理学家进行审查.
- 在5年内预测HGD/EAC进展的诊断准确度的比较.
主要成果:
- 与平均病理学家审查 (63%) 相比,TSP-9测试在检测进展到HGD/EAC的患者中显示出更高的灵敏度 (71%).
- 总共有24名患者在5年内进展到HGD/EAC.
- 在TSP-9测试显示了统计学上显著的改善病理学审查 (P = .01186).
结论:
- 在TSP-9测试中,病理学家在LGD患者的风险分层中表现优于病理学家.
- TSP-9测试为病理学审查变异性提供了解决方案,可能改善患者的治疗结果.
- 测试指导护理可以优化高风险患者的治疗干预措施,并减少低风险患者不必要的程序.
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