在染色内镜检查期间,对于正常的食道粘膜,是否需要随机活检? 来自基于人口的队列研究的证据
Wenlei Yang1, Mengfei Liu1, Zifan Qi1
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Genetics, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
BMC medicine
|March 1, 2026
概括
在Lugol的染色内镜检查期间,正常的食道粘膜的活检对于食道状细胞癌 (ESCC) 的种群级查是不必要的. 这一发现简化了查方案,减少了对低度内皮质瘤的不必要程序.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 内镜检查是指内镜检查.
背景情况:
- 食道状皮内瘤可能存在于粘膜中,在Lugol的染色内镜检查期间看起来正常.
- 从这种正常染色的粘膜中确定活检的必要性对于优化查方案至关重要.
研究的目的:
- 评估是否需要从正常染色的食道粘膜活检在卢戈尔的染色体检查期间,以对食道状细胞癌 (ESCC) 进行人口级查.
主要方法:
- 一个基于人口的查队列接受了卢戈尔的染色体内镜检查,包括从未染色和正常染色区域的活检.
- 分析包括641名ESCC或更严重病变的参与者,比较高度内皮质瘤/ESCC和ESCC特异性死亡率的累积发病率.
- 对配对组织进行了比较基因组分析.
主要成果:
- 在从正常染色的粘膜中诊断出低度内皮质瘤 (LGIN) 的个体中,在中位数9.5年的随访期间,没有发现新的高度内皮质瘤/ESCC病例.
- 在未染色的病变中LGIN显示,每100人中HGIN/ESCC的累计发病率为15.8.
- 患有正常染色病变的患者中没有发生ESCC相关的死亡,而未染色的病变在LGIN,HGIN和ESCC中具有显著的死亡率.
- 基因组分析显示,在正常染色的病变中,拷贝数量变异很小,而在未染色的病变中,变化很大.
结论:
- 在Lugol的染色内镜检查过程中,对正常染色的食道粘膜进行随机活检,对于人口级别的ESCC查是不必要的.
- 专注于未染色区域的活检对于检测显著的食道瘤和预防死亡更为关键.
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