内镜师结肠镜质量测量与便测试 (多目标便DNA或便免疫化学测试) 呈阳性后的随访结肠镜结果的关联:从新罕布什尔州结肠镜注册表的数据的回顾性横截面分析
Lynn F Butterly1,2,3, William M Hisey2,3, Christina M Robinson2,3
1Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
The American journal of gastroenterology
|April 17, 2024
概括
内镜师的质量在便检测结果呈阳性后显著影响结肠镜检查结果. 较高的腺瘤检测率 (ADR) 和临床显著的状聚检测率 (CSSDR) 减少了假阳性并增加了聚检测.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠癌查 结肠直肠癌查
- 医疗保健服务研究 医疗服务研究
背景情况:
- 便测试 (便免疫化学测试[FIT]或多目标便DNA[mt-sDNA]) 的阳性结果需要结肠镜检查.
- 便检测结果呈阳性后的阴性结肠镜检测可能表明便检测的准确性或内镜师的表现存在问题.
- 内镜师的质量,特别是腺瘤检测率 (ADR) 和临床显著的状息肉检测率 (CSSDR),是结肠镜疗效的关键因素.
研究的目的:
- 检查内镜检测率和在便检测结果呈阳性的结肠镜检查中多产量之间的关联.
- 评估内镜师质量如何影响便检查结果呈阳性后阴性结肠镜检查率.
- 为了确定高质量的内镜师在这个患者群体中检测到的显著多的频率.
主要方法:
- 使用了来自新罕布什尔州结肠镜注册表的数据.
- 在内镜术ADR和CSSDR的四分位数中比较了阴性结肠镜检查的频率和特定的多类型.
- 分析了对FIT或mt-sDNA测试呈阳性的结肠镜检查.
主要成果:
- 与更高的内镜ADR和CSSDR一起,观察到阴性结肠镜的频率较低,特别是在前两个四分位数.
- 对于第四个ADR四分位数中的内镜师来说,腺瘤检测率为63.3% (FIT+) 和62.8% (mt-sDNA+).
- 在第四个CSSDR四分位数中的内镜医生检测到29.2%的mt-sDNA+和13.5%的FIT+检查中检测到状状病变.
结论:
- 具有较低ADR和CSSDR的内镜检查者在便检查结果呈阳性后,内镜检查结果呈阴性结肠镜检查的频率明显更高.
- 推的基准目标包括FIT+或mt-sDNA+患者至少40%的ADR.
- 在mt-sDNA+患者中,建议的基准目标为至少20%的状状病变.
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