在没有GERD症状的患者中检测巴雷特食道的非内镜检测
medRxiv : the preprint server for health sciences
|April 8, 2025
概括
这项研究表明,非内镜查有效地检测到没有GERD症状的风险人群的巴雷特食道 (BE). 阴性测试表明BE的可能性非常低,扩大了查机会.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 分子诊断学 分子诊断
背景情况:
- 巴雷特食道 (BE) 查通常依赖于上部内镜 (EGD) 对于有GERD症状和危险因素的患者.
- 这种方法错过了没有GERD症状但具有其他风险因素的个体,这些人占食道腺癌 (EAC) 病例的很大一部分.
- 目前查的局限性凸显了在更广泛的风险人群中检测BE的非侵入性方法的需要.
研究的目的:
- 评估非内镜方法的有效性,以检测BE在个体有风险但没有GERD症状.
- 评估使用EsoCheck设备和EsoGuard甲基化试验用于BE查的可行性.
- 为了确定在这个目标人群中检测BE的流行率和预测值.
主要方法:
- 一项前性研究招募了132名接受结肠镜检查的患者,具有≥3个BE风险因素,没有GERD症状.
- 施用了EsoCheck封装气球,随后使用EsoGuard BE检测甲基化DNA标记面板对样品进行了分析.
- 阳性结果的患者接受了EGD;负面结果的患者提供了研究EGD来计算正预测值 (PPV) 和负预测值 (NPV).
主要成果:
- 该研究包括132名参与者 (平均年龄为60.7岁,主要是白人男性) 具有多个BE风险因素.
- 在大多数参与者中,EsoCheck和EsoGuard测定成功地被管理和分析.
- 对于BE检测,观察到PPV为33%和NPV为100%,在这个人群中估计BE患病率为8.4%.
结论:
- 使用EsoCheck和EsoGuard的非内镜查可以有效地在没有GERD症状但具有显著风险因素的患者中识别BE.
- 这种方法可以将BE查扩展到一个更大的,目前服务不足的风险人群.
- 一个负的非内镜测试结果显著降低了BE的概率,支持其在排除条件的实用性.
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