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The optimal endoscopic screening interval for detecting early gastric neoplasms

机译:内镜检查的最佳间隔时间,可早期发现胃肿瘤

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Background The optimal interval between endoscopic examinations for detecting early gastric neoplasms, including gastric adenomas, has not previously been studied. Objective To clarify the optimal interval between endoscopic examinations for the early diagnosis of both gastric cancers and adenomas. Design Retrospective study. Setting University-affiliated tertiary-care hospital, Seoul, Korea. Patients Patients who were treated for gastric neoplasms between January 2008 and August 2013. Interventions Questionnaire survey for interval between the penultimate endoscopy and diagnosis of a gastric neoplasm. A total of 846 patients were divided into 5 groups according to the interval between endoscopic examinations. Main Outcome Measurements The proportion of gastric neoplasms treated with endoscopic submucosal dissection and the proportion of advanced gastric cancers according to the interval between endoscopic examinations. Results In total, 197, 430, and 219 patients were diagnosed with gastric adenoma, early gastric cancer, and advanced gastric cancer, respectively. In multivariate analysis, the proportion of gastric neoplasms treated with endoscopic submucosal dissection was significantly higher in the ≤12 months, 12 to 24 months, and 24 to 36 months endoscopy interval groups than in the no endoscopy within 5 years group (all P <.001). In addition, the proportion of advanced gastric cancers was significantly lower in the ≤12 months and 12 to 24 months endoscopy interval groups than in the no endoscopy within 5 years group (all P <.001). Limitations Retrospective study and recall bias. Conclusion Annual endoscopy cannot facilitate the detection of endoscopically treatable gastric neoplasms compared with biennial or triennial endoscopy. We recommend biennial endoscopic screening for gastric neoplasms in order to increase the proportion of lesions discovered while they are still endoscopically treatable and to reduce the number of lesions that progress to advanced gastric cancer.
机译:背景技术以前尚未研究过用于检查早期胃肿瘤(包括胃腺瘤)的内镜检查之间的最佳间隔。目的明确内镜检查之间的最佳间隔,以早期诊断胃癌和腺瘤。设计回顾性研究。设在韩国首尔的大学附属三级医院。患者2008年1月至2013年8月之间接受胃肿瘤治疗的患者。干预措施问卷调查倒数第二次内窥镜检查与胃肿瘤诊断之间的间隔。根据内镜检查间隔时间,将846例患者分为5组。主要结果测量根据内镜检查间隔时间,内镜黏膜下剥离术治疗的胃肿瘤比例和晚期胃癌的比例。结果总共有197例,430例和219例被诊断为胃腺瘤,早期胃癌和晚期胃癌。在多变量分析中,内镜下黏膜下剥离术治疗的胃肿瘤的比例在≤12个月,12到24个月和24到36个月的内镜间隔组明显高于5年内无内镜检查的组(所有P <。 001)。此外,在≤12个月和12到24个月内镜检查间隔组中,晚期胃癌的比例显着低于5年内无内镜检查的组(所有P <.001)。局限性回顾性研究和回忆偏见。结论与两年期或三年期内窥镜检查相比,一年内窥镜检查不能促进内镜治疗的胃肿瘤的检测。我们建议每两年一次内镜筛查胃肿瘤,以增加在仍可通过内镜治疗的同时发现的病变比例,并减少进展为晚期胃癌的病变数量。

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