在初始内镜检查后巴雷特食道的患病率和预测因素:来自两个国家数据库的分析
Lovekirat Dhaliwal1, Amrit K Kamboj2, J Lucas Williams3
1Department of Internal Medicine, Louisiana State University Health, Shreveport, Louisiana.
概括
巴雷特食道 (BE) 在1.7%-3.4%的重复EGD患者中被发现,特别是那些具有多种风险因素的患者. 高质量的初始查至关重要,并考虑对特定高风险患者进行重复查.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 在瘤学瘤学.
背景情况:
- 目前的指导方针建议对具有巴雷特食道 (BE) 多种风险因素的个人进行一次性查食道胃道透镜 (EGD).
- 在初次负面检查后重复EGD时,BE的患病率和预测因素需要进一步调查.
研究的目的:
- 在初始EGD阴性后,在重复EGD时确定BE的患病率.
- 为了确定在重复EGD时检测到的BE的预测因子.
- 评估重复EGD查BE的有用性.
主要方法:
- 分析了两个大型的国家数据库 (GIQuIC和TriNetX),包括超过35万接受至少两次EGD的患者.
- 排除在最初EGD时检测到的BE或食道腺癌的患者.
- 多变量后勤回归以确定重复EGD时BE的独立风险因素.
主要成果:
- 在重复的EGD中,BE的患病率在GIQuIC中为1.7%,在TrinetX中为3.4%,占基线患病率的26%-45%.
- 大多数检测到的BE病例 (89%) 是非失塑性的.
- 随着风险因素的数量增加,BE的患病率增加,在高风险人群中为3% - 4% (GERD + ≥1风险因素).
结论:
- 在1.7%至3.4%的患者中,重复EGD确定了BE,在具有多个风险因素的患者中,其比率更高,这表明在初始查期间可能错过了诊断.
- 常规的重复内镜BE查不建议,但可以考虑精心选择的患者与GERD和多种风险因素,可能有助于非内镜工具.
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