胃癌内镜查在中等风险国家中的有效性-系统性审查和元分析
M B Mourato1,2, N Pratas2, A Branco Pereira2
1NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, LA-REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal.
United European gastroenterology journal
|August 2, 2025
概括
内镜查显示,在中等风险国家,早期检测胃癌是有前途的. 将其与结直肠查相结合可能具有成本效益,尽管数据有限.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 胃癌是中等风险国家癌症死亡的主要原因.
- 内镜查在高风险地区很常见,但其在中间设置中的价值尚不清楚.
- 这项研究系统地审查了胃癌内镜查在中等风险人群中的有效性和成本效益.
研究的目的:
- 为了评估上部胃肠道内镜查胃癌的有效性.
- 在中等风险国家评估内镜查的成本效益.
- 分析癌前疾病的检测率,胃癌 (整体和早期) 和胃癌特异性死亡率.
主要方法:
- 对上部胃肠道内镜查 (食道胃肠道内镜 - EGD) 的研究进行系统审查和元分析.
- 在Medline,Scopus,Embase和Web of Science进行的搜索截至2024年9月30日.
- 针对检测率和死亡率计算的聚合估计;根据查策略和地区进行的子组分析.
主要成果:
- 32项研究 (24项有效性,8项成本效益) 涉及404,159名个人.
- 综合检测率:25.5%用于癌前疾病,3.3%用于瘤病变,91.6%用于瘤病例中早期癌症.
- 直接EGD比预选择更能检测出癌前病症 (32.5%vs17.0%) 和早期癌症 (95.8%vs87.3%);成本效益更高,特别是在与结直肠查相结合时.
结论:
- 内镜查 (EGD) 在中等风险国家的胃癌早期检测具有显著的潜力.
- 关于生存率和死亡率的数据主要来自中国的研究,限制了概括性.
- 实施内镜查,特别是与结直肠查或风险分层进行整合,似乎是可行的和有效的.
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