关于巴雷特食道监测的AGA临床实践指南
Sachin Wani1, Margaret J Zhou2, Tarek Sawas3
1Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Gastroenterology
|October 22, 2025
概括
对于非形性形,有条件建议对巴雷特食道 (BE) 进行监测,但对于短段 (<1厘米) 则不建议. 强烈建议使用高清内镜与染色内镜进行高清内镜,以改善瘤检测.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 临床实践指南 临床实践指南
背景情况:
- 巴雷特食道 (BE) 是食道腺癌 (EAC) 的主要前体.
- 内镜监测旨在早期检测与BE相关的瘤并降低EAC死亡率.
研究的目的:
- 为患者提供基于证据的内镜监测建议.
- 为临床医生和患者提供最佳监测策略的指导.
主要方法:
- 使用了推评估,开发和评价 (GRADE) 框架的评级.
- 进行了证据审查,并使用了证据到决策框架.
- 解决了关键的临床领域,包括监测角色,成像,采样,生物标志物和化疗预防.
主要成果:
- 条件建议对非形性B.E.进行监测;反对对B.E.具有<1厘米柱状食道的监测.
- 强烈推高清白光内镜与染色内镜结合使用.
- 没有推增强采样技术或特定生物标志物;每日PPI治疗的有条件建议.
结论:
- 强调高质量的内镜检查,结构化活检协议,以及专家病理学来诊断BE瘤.
- 提供了关于监测间隔和失育症管理的指导.
- 突出了未来研究的证据差距,并促进了共享决策.
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