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首页> 外文期刊>Endoscopy International Open >Effectiveness of systematic alphanumeric coded endoscopy for diagnosis of gastric intraepithelial neoplasia in a low socioeconomic population
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Effectiveness of systematic alphanumeric coded endoscopy for diagnosis of gastric intraepithelial neoplasia in a low socioeconomic population

机译：系统字母数字编码内窥镜检查在低社会经济人群中诊断胃上皮内瘤变的有效性

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Background and study aims: In the Western world, gastric cancer (GC) usually presents at an advanced stage, carrying a high mortality rate. Studies have reported that 14?% to 26?% of GCs are missed at endoscopy up to 3 years before diagnosis. Systematic Alphanumeric Coded Endoscopy (SACE) has been proposed to improve quality of esophagogastroduodenoscopy (EGD) by facilitating a complete examination of the upper gastrointestinal tract. This prospective cross-sectional study was designed to determine the frequency of gastric intraepithelial neoplasia (GIN) by using the SACE approach in cohort of patients from low socioeconomic level. It also used non-targeted biopsies to evaluate the frequency of premalignant conditions. Patients and methods: A total of 601 consecutive asymptomatic or dyspeptic patients were enrolled between January 2013 and November 2014 at the Huacho regional hospital in Peru. The SACE method proposed by Emura et al, which divides the stomach into 5 regions and 21 areas, was routinely used for diagnosis. Biopsy samples were obtained from any endoscopically detected focal lesion. To evaluate gastric premalignant conditions, 4 non-targeted biopsies were taken. Results: A total of 573 patients were analyzed. The mean age was 57 years, and the female:male ratio was 1.9?:?1. In all cases, complete photo-documentation of the 21 gastric areas was achieved. The overall rate of detection of GIN was 2.8?%. Low-grade displasia, high-grade dysplasia, and adenocarcinoma were found in 13 (2.3?%), 2 (0.3?%), and 1 (0.2?%) of the patients, respectively. The prevalence of at least 1 premalignant condition was 31?%, and helicobacter pylori infection was found in 57?% of patients. Conclusions: Using the SACE approach and with proper training, we have reported herein a high frequency of GIN in patients from a low socioeconomic status. Gastric cancer detection can be improved in a Western endoscopy setting when SACE, as a screening method, is performed by a trained endoscopist.
机译：背景与研究目标：在西方世界，胃癌（GC）通常处于晚期，死亡率很高。研究报告称，在诊断之前最多3年内镜检查会漏掉14％至26％的GC。已经提出系统字母数字编码内窥镜检查（SACE），以通过促进对上消化道的彻底检查来提高食管胃十二指肠镜检查（EGD）的质量。这项前瞻性横断面研究旨在通过SACE方法从社会经济水平较低的患者队列中确定胃上皮内瘤变（GIN）的频率。它还使用非靶向活检来评估恶变前疾病的发生频率。患者和方法：2013年1月至2014年11月之间，秘鲁华乔地区医院共纳入601例无症状或消化不良的患者。 Emura等人提出的SACE方法将胃分为5个区域和21个区域，通常用于诊断。从任何内窥镜检查到的病灶处获得活检样品。为了评估胃癌前病变，进行了4次非靶向活检。结果：共分析573例患者。平均年龄为57岁，男女之比为1.9？：？1。在所有情况下，均获得了21个胃区域的完整照片记录。 GIN的总检出率为2.8％。分别在13例（2.3％），2例（0.3 %%）和1例（0.2 %%）的患者中发现了低度增生，高度不典型增生和腺癌。至少有1种恶性疾病的患病率为31％，并且在57％的患者中发现了幽门螺杆菌感染。结论：使用SACE方法并经过适当的培训，我们在此报告了社会经济地位低下患者的GIN发生率较高。如果由受过训练的内镜医师执行SACE作为筛查方法，则可以在Western内窥镜检查环境中改善胃癌的检测。

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