监视内镜在严重食道炎的低收益率:1700名患者的回顾性队列研究
T Matthews1, C Barry2, S M Connor2
1Department of Gastroenterology, The Mater Hospital, Dublin, Ireland. thomasmatthews@mater.ie.
Digestive diseases and sciences
|August 12, 2025
概括
常规内镜监测严重食道炎 (LA等级C/D) 的诊断收益率很低,用于检测恶性瘤和巴雷特食道 (BE). 当前的指导方针可能需要修订,以优化医疗保健资源使用.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 目前的指导方针建议对严重食道炎进行监视内镜,以确定隐性恶性瘤和巴雷特食道 (BE).
- 这种监测实践的临床效用和经济影响仍然不清楚.
研究的目的:
- 评估严重食道炎 (LA等级C/D) 患者监视内镜的诊断产量.
- 为了确定恶性瘤和BE的预测因素.
- 评估这一监控战略对资源的影响.
主要方法:
- 对1700名患有严重食道炎的患者进行了回顾性队列研究.
- 使用内镜和组织学数据库分析监测结果.
- 单变量和多变量逻辑回归以确定与恶性瘤,BE和监测的关联.
主要成果:
- 只有6例食道癌 (0.35%) 被诊断出;3例在指数和1例在717名重新评估患者的监测期间.
- 在重新评估的患者中,巴雷特食道在6.7%的患者中被新确诊,没有发现隐性失质性.
- 在没有重新评估的980名患者中没有检测到恶性瘤;总监测成本为580,215.15欧元.
结论:
- 对严重食道炎 (LA级C/D) 的常规内镜监测表明诊断产量低,相关成本高.
- 调查结果表明,需要修订当前的指导方针,可能有利于风险分层的后续行动,以改善医疗保健资源分配.
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