Wai Chun Tao, Yeoh Khay Guan, Ho Khek Yu, Kang Jin Yong, Lim Seng Gee
Division of Gastroenterology, Department of Medicine, National University Hospital, Singapore.
Gastrointest Endosc. 2002 Oct;56(4):548-51. doi: 10.1067/mge.2002.128493.
The aim of this study was to determine the frequency of diagnosis of significant disease by EGD in Asian patients of various ages with simple dyspepsia.
Database records of 10,488 consecutive patients undergoing EGD between 1992 and 1998 were analyzed. The frequency of significant upper GI disease (defined as esophagitis, peptic ulcer, and cancer) in patients presenting with simple dyspepsia was determined for various age groups.
For the indication simple dyspepsia, 5066 (48.3%) EGDs were performed. At 988 (19.5%) EGDs, significant disease was noted (peptic ulcer 14.9%, esophagitis 5.0%, stomach cancer 0.47%, esophageal cancer 0.06%). There was a positive correlation between disease frequency and increasing age. The cumulative percentages of significant disease by age group were as follows: 10.8% in patients less than 35 years of age, 11.9% for those less than 40 years old, 13.7% for patients less than 45 years of age, and 19.5% overall. The cumulative frequencies of gastric cancer by age group were as follows: 0.68 of 1000 EGDs in patients less than 35 years of age, 1.15 of 1000 EGDs in patients less than 45 years old, and 9.60 of 1000 EGDs in patients greater than 45 years of age.
The present study provides data to assist decision-making regarding the use of EGD in the patient population of Singapore. For patients with simple dyspepsia residing in Singapore, an age threshold of 45 years is reasonable inasmuch as gastric cancer is rarely found at endoscopy in younger patients. The age threshold for EGD for simple dyspepsia for Asians residing in other parts of the world would have to be determined based on the local prevalence of gastric cancer.
本研究的目的是确定不同年龄的亚洲单纯性消化不良患者通过上消化道内镜检查（EGD）诊断出重大疾病的频率。
分析了1992年至1998年间连续接受EGD检查的10488例患者的数据库记录。确定了不同年龄组单纯性消化不良患者中重大上消化道疾病（定义为食管炎、消化性溃疡和癌症）的频率。
因单纯性消化不良这一适应症进行了5066例（48.3%）EGD检查。在988例（19.5%）EGD检查中发现了重大疾病（消化性溃疡14.9%，食管炎5.0%，胃癌0.47%，食管癌0.06%）。疾病频率与年龄增长呈正相关。各年龄组重大疾病的累积百分比分别为：35岁以下患者为10.8%，40岁以下患者为11.9%，45岁以下患者为13.7%，总体为19.5%。各年龄组胃癌的累积频率分别为：35岁以下患者每1000例EGD检查中有0.68例，45岁以下患者每1000例EGD检查中有1.15例，45岁以上患者每1000例EGD检查中有9.60例。
本研究提供的数据有助于新加坡患者人群中关于使用EGD的决策。对于居住在新加坡的单纯性消化不良患者，45岁的年龄阈值是合理的，因为年轻患者在内镜检查中很少发现胃癌。居住在世界其他地区亚裔单纯性消化不良患者进行EGD检查的年龄阈值必须根据当地胃癌患病率来确定。
