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消化不良的基于年龄和风险的分层:重新定义临床显著和恶性发现的内镜值
Oren Gal1, Dorin Nicola1, Amir Mari2
1Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera 38100, Israel.
Clinics and practice
|January 27, 2026
概括
50岁以上的年龄和警报症状显著增加了临床显著发现 (CSF) 和恶性瘤的风险在胃镜检查消化不良期间. 这些因素可以帮助指导选择性内镜转诊,以获得更好的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 诊断内镜检查 诊断内镜检查
- 在瘤学瘤学.
背景情况:
- 消化不良是胃镜检查的常见原因之一.
- 恶性瘤和临床显著发现 (CSF) 的诊断产量通常很低.
- 对于内镜转诊,需要改善风险分层.
研究的目的:
- 为了评估消化不良患者胃镜的诊断产量.
- 调查年龄,种族和CSF和恶性瘤警报症状的预测价值.
主要方法:
- 对3022名因消化不良而接受胃镜检查的患者进行了回顾性单中心研究.
- 多变量后勤回归用于识别CSF的预测因子.
- 对最佳年龄值进行接收机操作特征 (ROC) 分析.
主要成果:
- 在55.9%的患者中出现功能性消化不良;在12.8%的患者中出现癌前病变;在0.79%的患者中出现恶性病变.
- 年龄≥50岁和警报症状独立预测CSF和恶性瘤.
- 最佳年龄值:脑脊髓炎的50 (AUC=0.65),恶性瘤的54 (AUC=0.72).
结论:
- 年龄≥50岁和警报症状是脑脊髓炎和消化不良症恶性病的关键预测因素.
- 支持对胃镜推的选择性方法.
- 来自ROC的年龄门可以为特定区域的风险分层策略提供信息.
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