Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, the Second Military Medical University, Shanghai, China.
Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, the Second Military Medical University, Shanghai, China; National Clinical Research Center for Digestive Diseases, Shanghai, China.
Gastrointest Endosc. 2018 Sep;88(3):466-474.e1. doi: 10.1016/j.gie.2018.05.003. Epub 2018 May 9.
Gastric cancer (GC) is the fourth most common cancer and the fourth leading cause of cancer death worldwide. In some Asian countries, screening EGD has greatly improved the survival rate. However, patients' discomfort and the need for sedation may limit adherence to screening programs. Previous studies have shown good tolerance and good agreement of magnetically controlled capsule gastroscopy (MCCG) with EGD. This study was designed to assess the application of MCCG in GC detection in an asymptomatic population.
In this observational cohort study, 3182 asymptomatic individuals undergoing MCCG in 99 participating medical examination centers from April to December 2016 were enrolled. Patients with ulcers and suspected malignancies were referred for gastroscopy and biopsy. The detection rate of GC and focal lesions were used to explore the application of MCCG in asymptomatic individuals.
Seven patients (0.22%) were diagnosed with GC among the enrolled 3182 individuals, accounting for 0.74% (7/948) in patients over 50 years. No gender disparity was observed. EGD and biopsy confirmed adenocarcinoma in all cases of suspected malignancy. Benign polyps, gastric ulcers, and submucosal tumors were found in 10.4%, 4.9%, and 3.6% of patients, respectively. There was a trend for the prevalence of focal lesions to increase with age. MCCG examination proved to be safe.
MCCG can detect cancer and benign lesions and is safe and clinically feasible in a large population. Studies of its role in a screening program should be considered.
胃癌(GC)是全球第四大常见癌症和第四大癌症死亡原因。在一些亚洲国家,内镜筛查极大地提高了生存率。然而,患者的不适和镇静需求可能会限制其对筛查计划的依从性。先前的研究表明,磁控胶囊胃镜(MCCG)具有良好的耐受性,与内镜检查具有很好的一致性。本研究旨在评估 MCCG 在无症状人群中用于 GC 检测的应用。
在这项观察性队列研究中,纳入了 2016 年 4 月至 12 月期间在 99 个参与体检中心接受 MCCG 的 3182 名无症状个体。对有溃疡和疑似恶性肿瘤的患者进行胃镜检查和活检。GC 和局灶性病变的检出率用于探索 MCCG 在无症状个体中的应用。
在纳入的 3182 名个体中,有 7 名(0.22%)被诊断为 GC,其中 50 岁以上患者的检出率为 0.74%(7/948)。未观察到性别差异。所有疑似恶性肿瘤患者的 EGD 和活检均证实为腺癌。10.4%、4.9%和 3.6%的患者分别发现良性息肉、胃溃疡和黏膜下肿瘤。局灶性病变的患病率随年龄增长呈上升趋势。MCCG 检查证明是安全的。
MCCG 可检测癌症和良性病变,在大人群中安全且具有临床可行性。应考虑研究其在筛查计划中的作用。