重新评估胃潰瘍重估:在19年的回顧性對照研究中,低惡性病發率和高成本
Thomas Matthews1, Mark Vesey2,3, Aditya Billur3
1Department of Gastroenterology, Mater Misericordiae University Hospital, Dublin, Ireland. thomasmatthews@mater.ie.
Journal of gastrointestinal cancer
|December 1, 2025
概括
具有良性特征和适当组织学的胃 (GUs) 的例行重新评估提供了最小的益处,并产生了高成本. 针对可疑的选择性方法在胃癌检测和资源分配方面更有效.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 胃的常规内镜再评估是排除恶性瘤的标准实践.
- 普遍GU监测的必要性和成本效益越来越受到质疑,特别是在胃癌发病率低至中等的地区.
研究的目的:
- 评估在GU中重复胃镜指南的遵守情况.
- 为了确定恶性瘤的预测因素在GU.
- 评估与GU重新评估相关的诊断产量和医疗保健成本.
主要方法:
- 从56,874次胃镜 (2006年5月至2024年8月) 中对2132个指数GU进行了回顾性分析.
- 收集的数据包括人口统计,内镜和组织学发现.
- 恶性结局通过组织学数据库跟踪;逻辑回归确定恶性预测因素.
主要成果:
- 胃恶性瘤在4% (86/2132) 的GU中被发现,96%在初始活检时被检测出来.
- 宏观性关注是最强的恶性瘤预测因素 (OR 66.9),其次是年龄较大,男性性别和非腹腔位置.
- 良性的常规监测没有导致癌症;重新评估成本超过100万欧元,占内镜工作负载的2.5%.
结论:
- 常规重新评估良性GUs与适当的组织学提供最小的诊断价值和显著的成本.
- 建议采用选择性监测策略,重点关注具有可疑特征的,不充分的活检或持续的症状.
- 这种方法优化了资源分配,减少了不必要的内镜手术.
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