预测从结肠囊内镜转换到传统光学内镜转换的因素 - - 来自CESCAIL研究的发现
Ian Io Lei1,2, Ioanna Parisi3, Anirudh Bhandare4
1Institute of Precision Diagnostics & Translational Medicine, University Hospital of Coventry and Warwickshire, Clifford Bridge Rd, Coventry, CV2 2DX, England. Brian.lei@uhcw.nhs.uk.
结肠囊内镜 (CCE) 是结肠镜的替代方案,但转化率可能很高. 具有较低便血红蛋白 (f-Hb) 水平的非吸烟者不太可能需要转换为常规结肠镜 (CCC).
科学领域:
- 胃肠病学 胃肠病学
- 医疗器械 医疗器械
- 诊断内镜检查 诊断内镜检查
背景情况:
- 结肠囊内镜 (CCE) 为部分患者提供了传统结肠镜的不那么侵入性的替代方案.
- 然而,CCE的局限性,包括低完成率和无法进行活检,往往需要转换为传统结肠镜 (CCC).
研究的目的:
- 确定肠道清洁问题,囊分泌,病理检测和CCC的预测因素.
- 改进患者选择并优化CCE利用率.
主要方法:
- 在CESCAIL研究中 (2021年11月至2024年6月) 对603名接受CCE的患者进行前性分析.
- 检查了患者人口统计,并发病,药物和实验室结果与CCC之间的关联.
- 使用LASSO,线性和后勤回归来进行预测因素分析.
主要成果:
- 便血红蛋白 (f-Hb) 和吸烟的升高与CCC率的增加显著相关 (分别为OR=1.48和1.44).
- 糖尿病与肠道准备较差相关 (OR=0.40).
- 酒精,吸烟,心理状况和血红蛋白水平影响了多体检测;抗抑郁药和β阻断剂影响了多体大小.
结论:
- 低f-Hb水平的非吸烟者表明需要CCC的可能性降低.
- 优化患者选择对于最大限度地降低CCC率至关重要.
- 为了提高成本效益,需要进一步验证开发CCE转换评分系统 (CECS).
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