错过早期胃癌的危险因素:基于内镜下膜剖析后病理确诊病例的回顾性队列研究
Kaier Gu1, Tianer Gu2, Wei Xie3
1Department of Internal Medicine, Shaoxing Maternity and Child Health Care Hospital, Shaoxing, Zhejiang, China.
Surgical endoscopy
|February 9, 2026
概括
错过的早期胃癌 (MEGC) 在22%的病例中发生,男性性别和年长的内镜医生是危险因素. 优化内镜协议和培训可以降低MEGC率.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 在瘤学瘤学.
背景情况:
- 在食道胃二透镜检查 (EGD) 期间,早期胃癌 (EGC) 检测率可能不足于最佳水平.
- 在最初的内镜检查中,很大比例的EGC病例被遗漏了.
研究的目的:
- 确定与错过的早期胃癌 (MEGC) 相关的独立风险因素.
- 分析MEGC的原因和潜在的可避免性.
- 探索内镜师经验和MEGC率之间的相关性.
主要方法:
- 追溯分析763个病理确认的EGC病变.
- 根据先前的EGD病史,将患者分为最初检测到的EGC (IDEGC) 和MEGC组.
- 多变量分析以确定MEGC的独立风险因素.
主要成果:
- 整体MEGC率为22.0%,其中MEGC率为22.0%.
- 对MEGC的独立风险因素包括男性性别和内镜使用者年龄≥45岁.
- 保护因素包括较大的损伤大小 (≥12毫米),镇静,较长的观察时间 (≥5分钟) 和图像增强内镜 (IEE).
- MEGC的主要原因是暴露 (35.1%),感知 (34.5%) 和采样错误 (29.2%).
- 大约50.6%的MEGC病例是可以避免的.
- 较高的年内镜 EGD 量与技术上可归因的 MEGC 率相反相关.
结论:
- 通过针对高风险个体 (男性) 和优化内镜协议,可以减轻MEGC风险.
- 实施适当的观察时间,镇静和IEE技术对于减少错过诊断至关重要.
- 建议加强内镜师,特别是老年人的先进技术培训.
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