实施BSG/ACPGBI/PHE多斑瘤监测指南可安全降低查队列中的监测负担:一个虚拟模型研究
Roisin Stack1,2, Jayne Doherty3,2, Neil O'Moráin3,2
1Centre of Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland stack.roisin@gmail.com.
BMJ open gastroenterology
|September 12, 2023
概括
英国胃肠病学学会新指导方针对多斑切除术的监测安全地减少了肠癌查计划中的结肠镜需求. 追溯分析显示,监测活动显著减少,在推迟程序上可接受的病理检测.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 英国胃肠病学会/大不列颠和爱尔兰结肠直肠病学协会/公共卫生英格兰 (BSG/ACPGBI/PHE) 2019年指导方针旨在优化多斑切除术监测.
- 基于便免疫化学测试的肠癌查 (BS) 计划需要有效的监测策略.
研究的目的:
- 评估2019年BSG/ACPGBI/PHE多斑瘤监测指南对国家BS队列内的监测活动和病理检测的影响.
- 将BSG/ACPGBI/PHE 2019指南与之前的欧洲指南 (EUQA 2013) 进行比较.
主要方法:
- 在2015-2016年进行的890次BS结肠镜的回顾性审查,随着5年的前性随访.
- 虚拟应用BSG/ACPGBI/PHE 2019指南来计算推迟结肠镜检查和检查病理学.
- 监测间隔与EUQA 2013年指南的比较.
主要成果:
- 随着对2019年BSG/ACPGBI/PHE指南的追溯应用 (p<0.0001),监测量显著减少 (n=221).
- 在330个"可能推迟"的手术中,没有发现癌症.
- 在BSG/ACPGBI/PHE队列中,不到10% (n=30) 的结肠镜检查中发现了高风险发现.
结论:
- BSG/ACPGBI/PHE 2019指南可以安全地减少BS课程中的结肠镜检查需求.
- 在推迟结肠镜检查中观察到可接受的病理检测率,支持指南的实施.
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