Paterson H M, McCole D, Auld C D
Dumfries and Galloway Royal Infirmary, Dumfries, Scotland, UK.
Endoscopy. 2006 May;38(5):503-7. doi: 10.1055/s-2006-925124.
There is conflicting evidence regarding the ability of open-access endoscopy to detect oesophageal and gastric cancers at an earlier stage. The aim of the study was to assess the impact, with regard to earlier diagnosis of oesophageal and gastric cancer, of the first 10 years of a regional open-access endoscopy service in the Dumfries and Galloway region of Scotland.
Data were retrieved from prospectively compiled endoscopy and cancer registry databases. Route of referral (open-access vs. outpatient vs. inpatient), presenting symptoms (alarm vs. benign) and UICC disease stage in consecutive 5-year periods (1994 - 1998 and 1999 - 2003) were compared.
386 oesophagogastric cancers were identified (179 during 1994 - 1998 and 207 in 1999 - 2003). The number of patients undergoing endoscopy increased from 500 per annum prior to the open-access service to 7359 during 1994 - 1998 and 9701 in 1999 - 2003. Patient age, route of referral and presenting symptoms were unchanged. There was no improvement in disease stage at diagnosis (stage I, 7 % vs. 7 %; stage II, 16 % vs. 17 %; stage III, 31 % vs. 28 %).
Despite a 32 % increase in endoscopy workload, the provision, over 10 years, of a regional open-access endoscopy service was not associated with earlier detection of oesophageal or gastric cancer.
关于开放式内镜检查能否在更早阶段检测出食管癌和胃癌，证据存在冲突。本研究旨在评估苏格兰邓弗里斯和加洛韦地区一项区域性开放式内镜检查服务开展的头10年，对食管癌和胃癌早期诊断的影响。
数据取自前瞻性编制的内镜检查和癌症登记数据库。比较了转诊途径（开放式、门诊、住院）、呈现症状（警示性、良性）以及连续5年期间（1994 - 1998年和1999 - 2003年）的国际抗癌联盟（UICC）疾病分期。
共识别出386例食管胃癌（1994 - 1998年期间179例，1999 - 2003年期间207例）。接受内镜检查的患者数量从开放式服务开展前的每年500例增加到1994 - 1998年期间的7359例以及1999 - 2003年期间的9701例。患者年龄、转诊途径和呈现症状均未改变。诊断时的疾病分期没有改善（I期，7%对7%；II期，16%对17%；III期，31%对28%）。
尽管内镜检查工作量增加了32%，但在10年期间提供的区域性开放式内镜检查服务与食管癌或胃癌的早期检测并无关联。
