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首页> 外文期刊>Hepato-gastroenterology. >Endoscopic and histological diagnosis on upper gastrointestinal cancer screening.
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Endoscopic and histological diagnosis on upper gastrointestinal cancer screening.

机译：上消化道癌筛查的内镜和组织学诊断。

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BACKGROUND/AIMS: Screening endoscopy for upper gastrointestinal cancer has come into wide use in Japan. We aim to clarify the limitation of its endoscopic diagnosis and contribution of histological biopsy on routine endoscopy. METHODOLOGY: For consecutive 1184 patients (696 men and 488 women, average age of 57 years) undergoing routine esophagogastroduodenoscopy, we prospectively evaluated endoscopic diagnosis with regard to grade of malignancy (definitely cancer, E5; probably cancer, E4; dysplasia/adenoma or indeterminate malignant, E3; probably benign, E2; and definitely benign, E1). Histological grade was defined as H5 (cancer), H4 (probably cancer), H3 (dysplasia/ adenoma or indeterminate malignant), H2 (probably benign), and H1 (definitely benign) in 267 patients undergoing endoscopic forceps biopsy. We analyzed the accuracy of endoscopic and histological biopsy diagnosis. RESULTS: Incidence of neoplastic lesions including H3, H4, and H5 was 0% in E1 (0/978), 2% in E2 (3/132), 19% in E3 (6/31), 33% in E4 (3/9), and 100% in E5 lesions (34/34). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of endoscopic diagnosis for these neoplastic lesions were 94%, 97%, 58%, 99%, and 97%, respectively. CONCLUSIONS: Better awareness of its endoscopic features and appropriate endoscopic biopsy is essential in the diagnosis of upper gastrointestinal cancer on screening endoscopy.
机译：背景/目的：筛查上消化道癌的内窥镜检查在日本已经广泛使用。我们旨在阐明其内窥镜诊断的局限性和组织活检对常规内窥镜检查的贡献。方法：对于连续1184例患者（696例男性和488例女性，平均年龄57岁）接受常规食管胃十二指肠镜检查，我们前瞻性地评估了内镜检查对恶性程度（绝对癌症，E5;可能是癌症，E4;发育异常/腺瘤或不确定）的诊断。恶性E3;可能是良性E2;也肯定是良性E1）。在267例接受内窥镜钳活检的患者中，组织学等级定义为H5（癌症），H4（可能是癌症），H3（发育不良/腺瘤或不确定的恶性），H2（可能是良性）和H1（一定是良性）。我们分析了内镜和组织学活检诊断的准确性。结果：包括H3，H4和H5在内的肿瘤性病变的发生率分别为：E1（0/978）为0％，E2（3/132）为2％，E3（6/31）为19％，E4为33％（3 / 9），以及100％的E5病变（34/34）。这些肿瘤性病变的敏感性，特异性，阳性预测值，阴性预测值和内镜诊断准确性分别为94％，97％，58％，99％和97％。结论：更好地了解其内镜特征和适当的内镜活检对筛查内镜诊断上消化道癌至关重要。

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