Bresky G, Mata A, Llach J, Ginis M A, Pellisi M, Soria M T, Fernandez-Esparrach G, Mondelo F, Bordas J M
Endoscopy Unit, Gastroenterology Department, Institut de Malalties Digestives, Hospital Clínic Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Hepatogastroenterology. 2003 Nov-Dec;50(54):2264-6.
BACKGROUND/AIMS: It is known that patients with pernicious anemia have a higher risk of gastric neoplasms. However, the optimal endoscopic follow-up in these patients has not been properly defined. This study was aimed to assess the usefulness of an endoscopic follow-up program.
We analyzed the endoscopic and histological findings of the first endoscopy performed in a group of 128 patients with the diagnosis of pernicious anemia who were referred to the Endoscopic Unit, and we evaluated the results of the biannual follow-up endoscopies made to 68 of them.
The initial endoscopy did not provide evidence of any lesions in 107 patients (83.5%), and polypoid lesions were found in 12 cases (9.4%). The histological results showed gastric dysplasia in 3 patients (2.3%) and carcinoid tumor in 2 cases (1.6%). No cases of gastric carcinoma were found. During the endoscopic follow-up of 68 patients, in 52 of them (76.8%) there were no endoscopic findings, and raised lesions were detected in 8 patients (11.8%). Three cases of gastric dysplasia were found. No cases of gastric carcinoma or carcinoid were detected during the follow-up.
We suggest that a biannual endoscopic follow-up in not useful for the early detection of gastric neoplasms in patients with pernicious anemia.
背景/目的：已知恶性贫血患者患胃部肿瘤的风险较高。然而，这些患者的最佳内镜随访方案尚未明确界定。本研究旨在评估内镜随访方案的有效性。
我们分析了128例被诊断为恶性贫血并转诊至内镜科的患者首次内镜检查的内镜及组织学检查结果，并评估了其中68例患者每半年进行一次随访内镜检查的结果。
初次内镜检查时，107例患者（83.5%）未发现任何病变，12例患者（9.4%）发现息肉样病变。组织学检查结果显示，3例患者（2.3%）有胃发育异常，2例患者（1.6%）有类癌肿瘤。未发现胃癌病例。在对68例患者的内镜随访中，52例患者（76.8%）内镜检查无异常发现，8例患者（11.8%）发现隆起性病变。发现3例胃发育异常病例。随访期间未发现胃癌或类癌病例。
我们认为，每半年进行一次内镜随访对恶性贫血患者早期发现胃部肿瘤并无帮助。
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