不规则的Z-Line:进行剖析还是不进行剖析?
Amrit K Kamboj1, Srinivas Gaddam2, Simon K Lo2
1Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Amrit.Kamboj@cshs.org.
Digestive diseases and sciences
|August 1, 2024
概括
不规则的z线,食道和胃内膜之间的交点,通常不会发展为癌症. 常规活检和监测不规则的z线通常是不必要的和昂贵的.
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:
- 这条z线是状柱状结点,标志着食道和胃上皮之间的过渡.
- 不规则的z线涉及柱状粘膜,在胃食道结口上方延伸不到1厘米.
- 巴雷特食道的诊断是当有至少1厘米的柱状粘膜与肠道代塑性存在时.
研究的目的:
- 审查有关活检和监测不规则的z线的当前指南和证据.
- 讨论错误诊断不规则的z线为巴雷特食道的后果.
- 为Z线的内镜管理提供策略.
主要方法:
- 审查目前的内镜指南和文献.
- 对患有不规则的z线患者的瘤进展率的分析.
- 讨论诊断标准和管理策略.
主要成果:
- 目前的指导方针建议不要进行常规活检或监测没有明显异常的不规则z线.
- 研究表明,在不规则的z线患者中,缺少进展到高度发育不良或食道腺癌.
- 错误地将不规则的z线标记为巴雷特食道导致不必要的手术,增加成本和降低生活质量.
结论:
- 在内镜检查期间准确地标识别对于区分不规则的z线和巴雷特食道至关重要.
- 常规活检和监测不规则的z线没有得到当前证据的支持.
- 建议针对z线上可见异常的有针对性的活检,以排除瘤.
相关概念视频
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A z score (or standardized value) is measured in units of the standard deviation. It indicates how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
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