组织系统病理学测试客观风险分层巴雷特食道患者:来自多中心美国临床经验研究的结果
Nicolas A Villa1, Miguel Ordonez-Castellanos1, Michael Yodice2
1MultiCare Rockwood Digestive Health Center, Spokane, WA.
Journal of clinical gastroenterology
|July 2, 2024
概括
TSP-9测试有效地对巴雷特食道 (BE) 患者进行风险分层,识别患有非形性BE (NDBE) 的高风险个体,他们可能需要加强管理以预防食道腺癌 (EAC). 这有助于优化监控策略.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 巴雷特食道 (BE) 是食道腺癌 (EAC) 的前体.
- 目前对BE的监测指南缺乏有效的风险分层方法.
- 早期发现和治疗EAC对于改善患者的治疗结果至关重要.
研究的目的:
- 在临床实践中评估TSP-9测试对BE患者的风险分层.
- 评估TSP-9测试识别临床相关患者子集的能力.
- 确定TSP-9是否可以改善BE患者的管理决策.
主要方法:
- 对8080名在各种临床环境中患有BE的TSP-9测试结果进行了分析.
- 数据包括临床病理特征和诊断:非发育不良的BE (NDBE),不确定的发育不良 (IND) 和低度发育不良 (LGD).
- 评估了891名医生的医生订单.
主要成果:
- TSP-9将83.2%的患者归类为低风险,10.6%为中等风险,6.2%为高风险,在5年内进展为高度发育不良/EAC.
- 该测试提供了不同BE亚型 (NDBE,IND,LGD) 和患者人口统计数据的独立风险分层.
- TSP-9确定15.3%的NDBE患者具有中等/高风险,比LGD患者高6.4倍,预测5年进展风险分别为8.1%和15.3%.
结论:
- TSP-9测试确定了一个高风险的NDBE子组,其进展率与确认的LGD相当或超过.
- 这使得高风险NDBE患者的管理能够及时升级,从而有可能减少EAC发病率.
- 该测试通过确定大多数NDBE患者的低风险来支持当前的监测指南.
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