设备辅助肠镜检查发现小肠肿瘤的不一致率和其他诊断方式的风险因素:韩国肠道疾病研究协会(KASID)多中心研究。

IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Gut and Liver Pub Date : 2024-07-15 Epub Date: 2024-05-10 DOI:10.5009/gnl240030
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
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引用次数: 0

摘要

背景/目的:尽管成像和内窥镜技术不断进步,但小肠肿瘤的诊断方式仍是同时进行的。我们研究了每种诊断方式之间的差异率以及差异的预测因素:方法:我们从韩国基于网络的肠镜登记数据库中检索了同时接受设备辅助肠镜(DAE)和计算机断层扫描(CT)检查的确诊小肠肿瘤患者的数据。采用逻辑回归分析法分析了与差异相关的预测性风险因素:998例患者中,210例(21.0%)通过DAE诊断为小肠肿瘤,193例确诊为小肠肿瘤的患者同时进行了DAE和CT检查。在这些患者中,有 12 人(6.2%)的检查结果不一致。在 49 名接受 DAE 和视频胶囊内镜(VCE)检查的患者中,有 13 人(26.5%)的检查结果不一致。在多变量逻辑回归分析中,患者中没有明显的独立风险因素与 DAE 和 CT 的一致性相关。在多变量逻辑回归分析中,输红细胞与小肠肿瘤患者 DAE 和 VCE 的一致性呈负相关(几率比 0.163;95% 置信区间 0.026 至 1.004;P=0.050):对于小肠肿瘤,DAE 和 CT 的差异率为 6.2%,DAE 和 VCE 的差异率为 26.5%。尽管横断面成像(VCE 和 DAE 模式)有所发展,但差异仍然存在。对于需要大量输血但 VCE 检查结果不明显的小肠出血患者,考虑到漏诊小肠肿瘤的可能性,应将 DAE 作为下一步诊断方法。
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Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study.

Background/aims: Despite advances in imaging and endoscopic technology, diagnostic modalities for small bowel tumors are simultaneously performed. We investigated the discrepancy rate between each modality and predictive factors of discrepancy in patients with definite small bowel tumors.

Methods: Data of patients with definite small bowel tumors who underwent both device-assisted enteroscopy (DAE) and computed tomography (CT) were retrieved from web-based enteroscopy registry database in Korea. Predictive risk factors associated with discrepancy were analyzed using logistic regression analysis.

Results: Among 998 patients, 210 (21.0%) were diagnosed with small bowel tumor using DAE, in 193 patients with definite small bowel tumor, DAE and CT were performed. Of these patients, 12 (6.2%) showed discrepancy between examinations. Among 49 patients who underwent DAE and video capsule endoscopy (VCE) examination, 13 (26.5%) showed discrepancy between examinations. No significant independent risk factors were associated with concordance between DAE and CT in multivariate logistic regression analysis among the patients. In a multivariate logistic regression analysis, red blood cell transfusion was negatively associated with concordance between DAE and VCE in patients with small bowel tumor (odds ratio, 0.163; 95% confidence interval, 0.026 to 1.004; p=0.050).

Conclusions: For small bowel tumors, the discrepancy rate between DAE and CT was 6.2%, and 26.5% between DAE and VCE. Despite developments in cross-sectional imaging (VCE and DAE modalities), discrepancies still exist. For small bowel bleeding that require significant transfusion while showing insignificant VCE findings, DAE should be considered as the next diagnostic approach, considering the possibility of missed small bowel tumor.

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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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