Abu-Freha Naim, Lior Yotam, Shoher Shira, Novack Victor, Fich Alexander, Rosenthal Alexander, Etzion Ohad
aInstitute of Gastroenterology and Hepatology bSoroka Clinical Research Center (SCRC), Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Gastroenterol Hepatol. 2017 May;29(5):602-607. doi: 10.1097/MEG.0000000000000824.
The aim of this study was to assess the yield of endoscopic evaluation in isolated unintentional weight loss (UWL) patients compared with patients with weight loss and additional symptoms or signs.
A retrospective review of all patients who underwent an endoscopic evaluation for the investigation of UWL at Soroka University Medical Center between 2006 and 2012. Data on clinical indication, endoscopic, and laboratory finding were retrieved. Severe inflammation, ulcers, achalasia, and neoplasias were considered clinically significant endoscopic findings (CSEF) that could explain weight loss. Detection rates of CSEF were compared between endoscopic studies for which UWL was the sole indication (group 1) and those performed for UWL and at least one other indication (group 2).
During the study period, 1843 patients with UWL were evaluated with 2098 endoscopic procedures. Of these, 1540 underwent esophagogastroduodenoscopy (EGD) and 558 underwent colonoscopy. EGD was performed in 229 (14.8%) patients in group 1 (mean age: 60.9±16.4, 43.3% men), and in 1311 (85.2%) patients in group 2 (mean age: 60.5±18.5, 45% men). Pathological endoscopic findings were identified in 712 (46%) EGDs. Of these, 155 (10%) studies detected significant outcomes: six (3.9%) in group 1 and 149 (96.1%) in group 2. Of the 558 colonoscopies performed, 105 (18.8%) were performed in group 1 (mean age: 61.7±17.5, 43% men) and 453 (82.2%) in group 2 patients (mean age: 62.9±14.6, 49% men). Abnormal findings were found in 190 (33.8%) of the procedures. CSEF were found in 34 (6%) patients: two in group 1 and 32 in group 2.
The diagnostic yield of endoscopy for investigation of patients with UWL is non-negligible, and should be considered as part of its baseline evaluation, especially in older individuals and those who present with other gastrointestinal manifestations.
本研究旨在评估与伴有体重减轻及其他症状或体征的患者相比，单纯非故意体重减轻（UWL）患者的内镜检查评估结果。
回顾性分析2006年至2012年间在索罗卡大学医学中心因UWL接受内镜检查评估的所有患者。收集临床指征、内镜检查及实验室检查结果的数据。严重炎症、溃疡、贲门失弛缓症及肿瘤被视为可解释体重减轻的具有临床意义的内镜检查结果（CSEF）。比较以UWL为唯一指征的内镜检查研究（第1组）与因UWL及至少一项其他指征进行的内镜检查研究（第2组）中CSEF的检出率。
在研究期间，1843例UWL患者接受了2098次内镜检查。其中，1540例接受了食管胃十二指肠镜检查（EGD），558例接受了结肠镜检查。第1组229例（14.8%）患者接受了EGD检查（平均年龄：60.9±16.4岁，男性占43.3%），第2组1311例（85.2%）患者接受了EGD检查（平均年龄：60.5±18.5岁，男性占45%）。712例（46%）EGD检查发现了病理内镜检查结果。其中，155例（10%）检查发现了显著结果：第1组6例（3.9%），第2组149例（96.1%）。在进行的558例结肠镜检查中，第1组105例（18.8%）患者接受了检查（平均年龄：61.7±17.5岁，男性占43%），第2组453例（82.2%）患者接受了检查（平均年龄：62.9±14.6岁，男性占49%）。190例（33.8%）检查发现了异常结果。34例（6%）患者发现了CSEF：第1组2例，第2组32例。
内镜检查对UWL患者的诊断价值不可忽视，应作为其基线评估的一部分，尤其是在老年患者及伴有其他胃肠道表现的患者中。
