打开黑子:在食道癌查中定义真负结果 - - 一项基于人口的研究
Mengfei Liu1, Zeyu Yan1, Anxiang Liu2
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genetics, Peking University Cancer Hospital & Institute, Beijing, China.
BMC medicine
|November 7, 2025
概括
消化管癌查的负面结果应该区分正常染色的上皮和非失塑的Lugol.
科学领域:
- 胃肠病学和内镜检查
- 在瘤学瘤学.
- 公共卫生查 公共卫生查
背景情况:
- 目前的食道癌查消极性定义不考虑正常染色的上皮和非失塑性Lugol的未染色病变 (ND-LULs) 之间的风险差异.
- 这种风险的异质性需要对查负面性的精细定义,以改善患者分层和监测策略.
研究的目的:
- 重新定义食道癌的查负面性,通过评估严重形和上部 (SDA) 病变的发病风险.
- 根据SDA风险,确定ND-LUL和正常染色表皮的个体适当的重新查间隔.
主要方法:
- 一项基于社区的随机对照试验 (RCT) 招募了815名ND-LUL和14123名正常染色表皮的参与者.
- 对照组包括RCT的未查臂 (n=16,473) 和匹配的人口对照 (4075为ND-LULs,70,615为正常染色).
- 参与者被跟踪了长达10年的时间,Poisson回归和累积发病率函数用于比较SDA率.
主要成果:
- 在ND-LUL组中,SDA的累积发病率明显高于10年RCT对照组 (调整后IRR=3.16).
- 相反,正常染色组的SDA发病率明显低于RCT对照组 (调整后IRR=0.52).
- 在ND-LUL组的SDA超过了对照组在2-3年后,而在整个10年随访期间,在正常染色组中,SDA始终低于对照组.
结论:
- 具有正常Lugol染色的个体代表了对食道癌的真正查负面人群.
- 对于Lugol染色正常的个体,建议进行10年的查间隔.
- 建议在患有非失塑性Lugol的未染色病变的个体中进行2-3年较短的再查间隔.
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