Comparison of Diagnosis of Esophageal Motility Disorders by Chicago Classification Versions 3.0 and 4.0.

IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Journal of Neurogastroenterology and Motility Pub Date : 2023-07-30 DOI:10.5056/jnm22121
Jin Hee Noh, Kee Wook Jung, In Ja Yoon, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
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引用次数: 1

Abstract

Background/aims: We aim to investigate the diagnostic accuracy and differences between Chicago classification version 3.0 (CC v3.0) and 4.0 (CC v4.0).

Methods: Patients who underwent high-resolution esophageal manometry (HRM) for suspected esophageal motility disorders were prospectively recruited between May 2020 and February 2021. The protocol of HRM studies included additional positional change and provocative testing designed by CC v4.0.

Results: Two hundred forty-four patients were included. The median age was 59 (interquartile range, 45-66) years, and 46.7% were males. Of these, 53.3% (n = 130) and 61.9% (n = 151) were categorized as normalcy by CC v3.0 and CC v4.0, respectively. The 15 patients diagnosed of esophagogastric junction outflow obstruction (EGJOO) by CC v3.0 was changed to normalcy by position (n = 2) and symptom (n = 13) by CC v4.0. In seven patients, the ineffective esophageal motility (IEM) diagnosis by CC v3.0 was changed to normalcy by CC v4.0. The diagnostic rate of achalasia increased from 11.1% (n = 27) to 13.9% (n = 34) by CC v4.0. Of patients diagnosed IEM by CC v3.0, 4 was changed to achalasia based on the functional lumen imaging probe (FLIP) results by CC v4.0. Three patients (2 with absent contractility and 1 with IEM in CC v3.0) were newly diagnosed with achalasia using a provocative test and barium esophagography by CC v4.0.

Conclusions: CC v4.0 is more rigorous than CC v3.0 for the diagnosis of EGJOO and IEM and diagnoses achalasia more accurately by using provocative tests and FLIP. Further studies on the treatment outcomes following diagnosis with CC v4.0 are needed.

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芝加哥分类3.0版和4.0版对食管运动障碍诊断的比较。
背景/目的:我们旨在探讨芝加哥分类3.0版(CC v3.0)和4.0版(CC v4.0)的诊断准确性和差异。方法:前瞻性招募2020年5月至2021年2月期间因疑似食管运动障碍接受高分辨率食管测压(HRM)的患者。人力资源管理研究方案包括附加的位置变化和由CC v4.0设计的挑衅测试。结果:共纳入244例患者。年龄中位数为59岁(四分位数范围45-66岁),男性占46.7%。其中53.3% (n = 130)和61.9% (n = 151)分别被CC v3.0和CC v4.0分类为正常。经CC v3.0诊断为食管胃交界流出梗阻(EGJOO)的患者15例,经CC v4.0诊断为体位正常(n = 2)、症状正常(n = 13)。7例患者经CC v3.0诊断为食管运动不良(IEM),经CC v4.0诊断为食管运动正常。ccv4.0对贲门失弛缓症的诊断率由11.1% (n = 27)提高到13.9% (n = 34)。在CC v3.0诊断为IEM的患者中,4例根据CC v4.0的功能管腔成像探头(FLIP)结果改为贲门失弛缓症。3例患者(2例无收缩性,1例有IEM)通过CC v4.0刺激试验和钡食管造影新诊断为贲门失弛缓症。结论:CC v4.0比CC v3.0对EGJOO和IEM的诊断更严格,刺激试验和FLIP对贲门失弛缓症的诊断更准确。需要进一步研究CC v4.0诊断后的治疗结果。
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来源期刊
Journal of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility GASTROENTEROLOGY & HEPATOLOGY-CLINICAL NEUROLOGY
CiteScore
6.30
自引率
8.80%
发文量
96
期刊介绍: Journal of Neurogastroenterology and Motility (J Neurogastroenterol Motil) is a joint official journal of the Korean Society of Neurogastroenterology and Motility, the Thai Neurogastroenterology and Motility Society, the Japanese Society of Neurogastroenterology and Motility, the Indian Motility and Functional Disease Association, the Chinese Society of Gastrointestinal Motility, the South East Asia Gastro-Neuro Motility Association, the Taiwan Neurogastroenterology and Motility Society and the Asian Neurogastroenterology and Motility Association, launched in January 2010 after the title change from the Korean Journal of Neurogastroenterology and Motility, published from 1994 to 2009.
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