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在炎症性肠病患者中随机活检的额外产量:系统性审查和元分析
1Xijing Hospital of Digestive Diseases, Air Force Medical University (Fourth Military Medical University), Xi'an, China.
在炎症性肠道疾病患者的结直肠癌监测期间,随机活检 (RB) 产生了显著的额外发现. 对于患有原发性硬化性脑膜炎 (PSC) 的患者以及在没有高清设备的中心,RBs特别有益.
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:
- 关于随机活检 (RB) 在对炎症性肠病 (IBD) 患者的结直肠癌监测中的附加值的临床数据有限.
- 评估RB的诊断产量对于优化这种高风险群体的监测协议至关重要.
研究的目的:
- 在炎症性肠病 (IBD) 患者的结肠镜监测期间,系统地审查和元分析随机活检 (RBs) 的额外产量.
- 评估诸如研究开始日期和原发性硬化性脑脊髓炎 (PSC) 等因素对RB产量的影响.
主要方法:
- 在PubMed,Embase,Web of Science和Cochrane图书馆进行了系统的文献搜索.
- 来自37项研究的数据 (48个组,9051名患者) 被汇总在一起,以计算RBs的额外产量和检测率.
- 根据研究开始的年份和PSC患者的比例进行了子组分析.
主要成果:
- 额外的RB产量为每位患者10.34%和每位病变16.20%.
- 检测率为每名患者的1.31%,每个病变的2.82%.
- 在2011年后的研究中,产量下降,随着PSC患病率的增加,产量显著增加,在100%的PSC队列中,每位患者的产量达到56.05%,每位病变的产量达到45.22%.
结论:
- 随机活检为IBD患者的结直肠癌监测提供了显著的额外产量.
- RB的实用性受到PSC的流行和高清设备的可用性的影响.
- 建议将RB纳入,特别是在PSC的IBD患者和缺乏先进成像技术的中心.
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