测量内镜和组织学炎症之间的一致性,以及其对IBD相关的发育不良症的影响
Daniela Guerrero Vinsard1,2, Ryan Lennon3, Himaja Kumari Avvaru2
1Gastroenterology and Hepatology, Minneapolis VA Medical Center, Minneapolis, United States.
Endoscopy international open
|January 31, 2024
概括
在炎症性肠病 (IBD) 中的炎症会增加患有前癌性疾病 - - 发育不良症的风险. 然而,内镜和组织学炎症评估之间的一致性很差,这影响了结肠镜检查期间的失生症检测.
科学领域:
- 胃肠病学和肝病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 在炎症性肠道疾病 (IBD) 患者的慢性炎症结肠粘膜易患张症.
- 在监视结肠镜检查期间检测失生症依赖于有针对性的或随机的活检.
- 了解粘膜炎症对失育症检测的影响对于患者管理至关重要.
研究的目的:
- 为了研究粘膜炎症对可见和"不可见"生殖不良的检测的影响.
- 评估炎症严重程度的内镜和组织学评估之间的一致性.
- 为了确定炎症水平和IBD患者的发育不良的存在之间的关联.
主要方法:
- 对3437次IBD监测结肠镜检查的内镜和组织学数据进行了长达6年的横截面分析.
- 利用多项式模型来估计损伤类型和随机发育不良相对于炎症的几率.
- 采用卡帕统计数据来衡量内镜和组织学炎症评估之间的一致性.
主要成果:
- 在组织学和内镜炎症之间观察到较低的一致性 (Kappa = 0.4).
- 内镜炎症增加与管状腺瘤 (TVA) 的更高可能性相关 (OR 2.18,P=0.04).
- 随机发育不良的更高几率 (低级,高级和无限期) 与内镜和组织学炎症的增加显著相关 (P < 0.001 两者).
结论:
- 内镜和组织学炎症都与检测TVA和各种级别的随机发育不良的可能性增加有关.
- 内镜和组织学炎症之间的低一致性凸显了准确评估疾病活动的挑战.
- 这些发现强调了在IBD监测中考虑可见和随机活检的重要性,以优化发育不良的检测.
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