囊海绵测试在症状性反流病中的临床应用:一项国家前性队列研究
Siobhan Chien1,2, Paul Glen3, Gavin Bryce4
1School of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow, G61 1QH, UK. siobhan.chien6@nhs.scot.
囊海绵检测有效地分类反流患者,确定30%需要内镜检查. 这种方法有助于巴雷特的食道诊断,并优化了对症状性反流性疾病的内镜资源分配.
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:
- 囊海绵检测是一种基于生物标志物的食道细胞采集,在2020年在苏格兰全国实施,用于症状反流患者.
- 该战略旨在对患者进行分拣,减少COVID-19期间内镜服务压力,并将资源集中在高病理概率病例上.
研究的目的:
- 评估囊海绵测试在症状反流病中的实际临床应用和有效性.
- 评估囊海绵检测与内镜活检结果的诊断产量.
主要方法:
- 一项前性队列研究确定了1305名患者,他们在苏格兰11个卫生局进行了32个月的囊海绵测试.
- 分析了患者记录的人口统计,生物标志物结果 (TFF3/atypia/p53) 和临床管理,重点关注那些进行上部胃肠道 (UGI) 内镜的人.
主要成果:
- 在1385项测试中,79.6%的生物标志物检测结果为负. 70%的患者在没有进一步调查的情况下出院.
- 27.2%的患者接受了UGI内镜检查. 肠道代谢 (IM) 在16.6%的活检中被发现,这些患者的检测呈阳性或不足,与阳性生物标志物有很强的相关性.
- 0.9%的海绵阴性患者在活检上有IM或恶性病变,包括1例食道腺癌和3例胃恶性病变.
结论:
- 囊海绵检测有效地识别了约30%的症状反流患者需要UGI内镜.
- 该测试有助于在临床实践中诊断巴雷特食道.
- 退院患者的长期随访对于验证测试的持续效用至关重要.
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