高分辨率的微内镜改善食道癌症查和监测:基于国际随机对照试验的全球环境的影响
Mimi C Tan1, Zhengqi Li2, Kalpesh K Patel1
1Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Global Programs, Baylor College of Medicine, Houston, Texas.
Gastroenterology
|October 30, 2024
概括
高分辨率微内镜 (HRME) 与卢戈尔的染色内镜 (LCE) 结合,显著提高了食道状细胞瘤检测效率. 这种方法节省了不必要的活检,在全球卫生环境中节省了成本.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医疗技术 医疗技术 医学技术
背景情况:
- 使用Lugol的染色内镜 (LCE) 检测食道状细胞新生病 (ESCN) 的特异性有限.
- 高分辨率微内镜 (HRME) 在专家内镜医生使用时,已经显示出增强特异性和减少不必要的活检的潜力.
研究的目的:
- 评估HRME在国际,现实世界的全球卫生环境中的临床影响,效率和性能.
- 评估HRME在一系列医疗保健提供者的有效性,包括新手.
主要方法:
- 在中国和美国进行了一项国际随机对照试验.
- 接受ESCN查或监测的参与者被随机分配到LCE (标准) 或LCE + HRME (实验) 中.
- 主要结果测量了效率和临床影响,通过金标准共识病理学来验证.
主要成果:
- 在查中,HRME显著提高了诊断产量,从20.0%增加到51.7%.
- 大约65.2%的活检和59.7%的参与者可能会被挽救.
- 在HRME上错过了6例 (0.7%) 的瘤,新手内镜医生错过了3例高度的瘤.
结论:
- 一个低成本的微内镜,HRME,提高了ESCN查和监测的效率和临床影响,当与LCE一起使用时.
- HRME有可能减少不必要的活检,从而在ESCN普遍存在的地区大大节省成本.
相关概念视频
Endoscopic Procedures I: Esophagogastroduodenoscopy
71
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
71
Barrett Esophagus-I: Introduction
70
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
70
Endoscopic Procedures III: Video Capsule Endoscopy
83
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
83
Endoscopic Procedures II: Colonoscopy
58
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
58
Ultrasound II: Endoscopic Ultrasound and FibroScan
80
Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
Endoscopic Ultrasound (EUS):
80


