通过数学模拟模型确定检测幽门螺杆菌未感染胃肿瘤的最佳内镜筛查策略。

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastric Cancer Pub Date : 2024-09-01 Epub Date: 2024-06-27 DOI:10.1007/s10120-024-01525-2
Fumiaki Ishibashi, Kosuke Okusa, Yoshitaka Tokai, Toshiaki Hirasawa, Tomohiro Kawakami, Kentaro Mochida, Yuka Yanai, Chizu Yokoi, Yuko Hayashi, Shun-Ichiro Ozawa, Koji Uraushihara, Yohei Minato, Hiroyuki Nakanishi, Hiroya Ueyama, Mikinori Kataoka, Yuzo Toyama, Yuji Mizokami, Sho Suzuki
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引用次数: 0

摘要

背景:在幽门螺杆菌感染率较低的人群中进行食管胃十二指肠镜(EGD)筛查的有效性尚不清楚。本研究旨在制定一种最佳高效的胃肠镜筛查策略,以检测幽门螺杆菌未感染的胃肿瘤(HpNGNs):方法:回顾性分析了 12 家机构 2016 年至 2022 年的胃肠道造影数据。从数据库中计算出与年龄相关的 HpNGN 患病率、肿瘤生长率、缺失率和检测阈值大小。随后,利用临床数据建立了一个新型数学模型,该模型可同时模拟人口统计学变化和 HpNGN 检测。同时还比较了采用不同起始年龄(40/45/50 岁)和间隔时间(2/5/10 年)的筛查策略。结果测量了虚拟队列中所有肿瘤的检出率和检测所需次数(NNT):结果:分析了 519,368 例胃肠道造影和 97 例 HpNGN(34 例纯标志环细胞癌、26 例胃底腺型腺癌、30 例泡状胃腺瘤-覆盆子型和 7 例未分化型癌症)的数据。研究使用了一个时间跨度为 70 年的虚拟队列,模拟了 3465836 人的发病、增长和检测情况。在检出率大于 50%的策略中,从 45 岁开始间隔 5 年的筛查策略的 NNT 最低。采用这种策略,大多数 HpNGN 在得出结论时就能被检测出来:数学模拟模型显示,从 45 岁开始每 5 年筛查一次可有效帮助早期发现 HpNGN。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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A mathematical simulation model to determine the optimal endoscopic screening strategy for detection of H. pylori-naïve gastric neoplasms.

Background: The effectiveness of esophagogastroduodenoscopy (EGD) screening in cohorts with low Helicobacter pylori prevalence is unknown. This study aimed to develop an optimally efficient EGD screening strategy for detecting H. pylori-naïve gastric neoplasms (HpNGNs).

Methods: EGD data of 12 institutions from 2016 to 2022 were retrospectively analyzed. Age-related HpNGN prevalence, tumor growth rate, missing rate, and detection threshold size were calculated from the databases. Subsequently, using clinical data, a novel mathematical model that simultaneously simulated demographic changes and HpNGN detection was developed. Screening strategies using different starting ages (40/45/50 years) and intervals (2/5/10 years) were also compared. The detection rates of all tumors occurring within the virtual cohort and number-needed-to-test (NNT) were measured as outcomes.

Results: Data of 519,368 EGDs and 97 HpNGNs (34 pure signet ring cell carcinomas, 26 gastric adenocarcinomas of the fundic gland type, 30 foveolar gastric adenoma-Raspberry type, and seven undifferentiated-type cancer cases) were analyzed. A virtual cohort with a 70-year time horizon was used to simulate the occurrence, growth, and detection of 346,5836 people. Among the strategies with detection rate > 50%, the screening strategy with a 5-year interval starting at 45 years of age had the lowest NNT. Adopting this strategy, most HpNGNs were detected at < 20 mm in size, and the deep submucosal invasion rate was less than 30%.

Conclusions: A mathematical simulation model revealed that screening every 5 years starting at 45 years of age could efficiently assist in identifying HpNGNs at an early stage.

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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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