将内镜检查结果与病理学联系起来,以优化胃炎中的活检策略:来自大型队列研究的见解
Fadi Abu Baker1,2, Rawi Hazzan3,4, Oren Gal1
1Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera.
European journal of gastroenterology & hepatology
|August 14, 2025
概括
内镜检查结果可以表明Helicobacter pylori感染和胃炎的癌前状况,但组织学评估仍然至关重要. 某些内镜特征有助于风险分层,尽管它们的预测值不高.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 组织病理学 组织病理学
背景情况:
- 胃炎的内镜诊断往往缺乏与组织病理学的一致性.
- 准确的诊断对于管理胃炎和预防并发症至关重要.
研究的目的:
- 评估胃炎内镜检测结果和组织病理学发现之间的相关性.
- 确定病理结果的预测因素 (H. pylori,癌前疾病).
- 评估活检在常规临床实践中的作用.
主要方法:
- 对4927例带有活检的胃镜进行了回顾性分析.
- 后勤回归和ROC分析,以识别和评估H. pylori和癌前病变的内镜特征的预测准确性.
- 系统地记录内镜图案,严重程度和分布.
主要成果:
- 在33.6%的病例中检测到H. pylori,在13.5%的病例中检测到癌前状况.
- 结节性和侵蚀性升高的胃预测了H. pylori;缩性和侵蚀性升高的胃预测了癌前病变.
- 预测准确度对H. pylori中度 (AUC=0.60) 和癌前疾病 (AUC=0.74) 很好.
结论:
- 内镜特征和人口统计为胃炎病理学提供了适度的预测价值.
- 组织学评估对于准确的诊断和患者管理至关重要.
- 在修改当前的活检实践之前,需要进行前性验证.
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