食道功能测试识别了巴雷特食道患者患有瘤风险的病理性酸暴露
Edoardo Vespa1, Edi Viale1, Ernesto Fasulo1
1Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy; Faculty of Medicine, Università Vita-Salute San Raffaele, Milan, Italy.
概括
患病性食道酸暴露在近三分之一的巴雷特食道患者中持续存在,这些患者服用质子抑制剂 (PPI). 这种情况显著增加患食道瘤的风险.
科学领域:
- 胃肠病学 胃肠病学
- 食道疾病 食道疾病
- 在瘤学瘤学.
背景情况:
- 接受质子抑制剂 (PPI) 治疗的巴雷特食道 (BE) 患者仍然可能经历病态食道酸暴露.
- 食道功能测试可以评估酸暴露,并预测BE患者的疾病进展.
研究的目的:
- 确定食道功能测试在评估BE患者在PPI上的酸暴露中的作用.
- 为了评估BE患者瘤酸暴露时间 (AET) 的预测值.
主要方法:
- 追溯研究135个无症状的BE患者使用高分辨率测量和24小时的PPIpH阻抗测试.
- 病理性反流被定义为AET>6%. 用于评估AET对瘤的预测性能的接收器操作员特征分析.
主要成果:
- 尽管接受了PPI治疗,但有27%的患者表现出病态反流;其中67%的患者接受了标准剂量的PPI.
- 病理性逆流是瘤的唯一独立预测因子 (aOR,9.62;P < .001).
- AET ≥6%显示了瘤的良好预测性能 (AUC,0.816;77%的灵敏度;78%的特异性).
结论:
- 几乎三分之一的无症状的BE患者在PPI上表现出病态反流.
- 在接受标准剂量的PPI的三分之一患者中,观察到正常的AET.
- 病理性逆流与BE患者瘤发病风险增加九倍有关.
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