...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Gastrointestinal Endoscopy >Barrett's esophagus is frequently overdiagnosed in clinical practice: Results of the Barrett's Esophagus Endoscopic Revision (BEER) study
【24h】

Barrett's esophagus is frequently overdiagnosed in clinical practice: Results of the Barrett's Esophagus Endoscopic Revision (BEER) study

机译：Barrett食管在临床实践中经常被误诊：Barrett食管内镜修订（BEER）研究的结果

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background The published prevalence of Barrett's esophagus (BE) varies from 0.9% to 25%, in part because of differences in the endoscopic interpretation of the disease. Objective We studied the accuracy of diagnosis in 130 patients previously labeled as having BE. Our aim was to determine the interobserver consistency of endoscopic findings and assess the percentage of patients with confirmed BE versus those with a revised diagnosis. Design/Setting/Patients Patients previously diagnosed with BE of any length and due for surveillance endoscopy were eligible for study. Interventions After intensive consensus anatomic and endoscopic review, study patients underwent endoscopy and biopsy by 1 of 3 endoscopists. BE was defined as any length of columnar-lined esophagus with goblet cells. Main Outcome Measurements Patients were photographed/ videotaped for review by the other 2 endoscopists, and BE was either confirmed or revised. Results Eighty-eight patients (67.7%) had confirmed BE, and 42 (32.3%) had their diagnosis revised to no BE (95% confidence interval, 24.4%-41.1%) because there was no visible columnar-lined esophagus proximal to the gastric folds or no goblet cells were found on biopsy. BE length, site of previous endoscopy, age, sex, and hiatal hernia size were predictors of revision. All 3 endoscopists agreed on all confirmed BE cases and 38 of 42 of those revised. Limitations Retrospective analysis, possible sampling error. Conclusions BE is overdiagnosed in clinical practice with important implications for patient care including increased costs, reduced insurability, and psychological stress. The true BE cancer risk may also be underestimated. This study suggests the need for a better definition of the gastroesophageal junction, stricter accountability for BE diagnosis, and improved endoscopic education.
机译：背景技术Barrett食管（BE）的患病率从0.9％到25％不等，部分原因是内窥镜对疾病的解释存在差异。目的我们研究了130名先前标记为BE的患者的诊断准确性。我们的目的是确定内镜检查结果的观察者之间的一致性，并评估已确诊BE的患者与经诊断明确的患者的百分比。设计/设置/患者先前被诊断患有任何长度的BE并应进行监测内镜检查的患者均符合研究条件。干预措施经过深入共识的解剖学和内窥镜检查后，研究患者由3名内镜医师中的1名进行了内窥镜检查和活检。 BE被定义为具有杯状细胞的任何长度的柱状内衬食管。主要结果测量对其他2名内镜医师进行照相/录像以供检查，然后对BE进行确认或修订。结果88例患者（67.7％）确诊为BE，42例（32.3％）的诊断被修订为无BE（95％置信区间，24.4％-41.1％），因为在食管近端没有可见的柱状食管活检未发现胃皱褶或杯状细胞。 BE的长度，先前的内镜检查部位，年龄，性别和食管裂孔疝大小是翻修的预测指标。所有3名内镜医师均同意所有确诊的BE病例，其中42例经修订。局限性回顾性分析，可能存在抽样误差。结论BE在临床实践中被过度诊断，对患者护理具有重要意义，包括成本增加，可保性降低和心理压力。真正的BE癌症风险也可能被低估了。这项研究表明需要更好地定义胃食管连接，更严格的BE诊断责任以及改进内镜教育。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号