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系统内镜检查技术在食管鳞状细胞癌患者头颈部的窄带成像应用的技能提升研究:前瞻性多中心研究。

Skill-up study of systemic endoscopic examination technique using narrow band imaging of the head and neck region of patients with esophageal squamous cell carcinoma: Prospective multicenter study.

机构信息

Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan.

Department of Gastroenterology, Kameda Medical Center, Chiba, Japan.

出版信息

Dig Endosc. 2019 Nov;31(6):653-661. doi: 10.1111/den.13445. Epub 2019 Jun 20.

Abstract

OBJECTIVE

To evaluate the usefulness of a training program on endoscopic head and neck surveillance for beginner endoscopists.

METHODS

This prospective multicenter study included 13 beginner endoscopists from 10 institutions who received training in systematic observation techniques and diagnostic criteria, and the training involved hands-on learning. Between May 2016 and February 2017, enrolled patients with current or previously diagnosed esophageal squamous cell carcinomas underwent head and neck surveillance using narrow band imaging (NBI) endoscopy, and histologically confirmed head and neck squamous cell carcinoma (HNSCC) detection rates, endoscopic image quality, and examination times were compared before (group A) and after (group B) the training program. Maximum possible score for the endoscopic images was 30 points.

RESULTS

A total of 330 patients, comprising 181 in group A and 149 in group B, were enrolled. Three patients with HNSCC were detected in group A (1.7%) and in group B (2.0%; P = 1.000). Mean ± standard deviation (SD) examination times were 157 ± 71 s and 174 ± 109 s in groups A and B, respectively, (P = 0.073). Mean ± SD scores of the endoscopic images were 25.04 ± 5.47 points and 27.01 ± 4.35 points in groups A and B, respectively, (P < 0.001).

CONCLUSION

The HNSCC detection rate based on the use of NBI on patients with ESCC did not improve after the training program for beginner endoscopists; however, endoscopic image quality improved significantly after the training program.

摘要

目的

评估针对初级内镜医师的内镜下咽及颈部监测培训计划的有效性。

方法

本前瞻性多中心研究纳入了来自 10 家机构的 13 名初级内镜医师,他们接受了系统观察技术和诊断标准的培训,并进行了实践学习。2016 年 5 月至 2017 年 2 月,纳入的当前或既往诊断为食管鳞状细胞癌的患者接受窄带成像(NBI)内镜下咽及颈部监测,比较培训前后(A 组和 B 组)的头颈部鳞状细胞癌(HNSCC)检出率、内镜图像质量和检查时间。内镜图像的最高可能得分为 30 分。

结果

共纳入 330 例患者,A 组 181 例,B 组 149 例。A 组和 B 组分别检出 3 例(1.7%)和 2 例(2.0%)HNSCC(P=1.000)。A 组和 B 组的平均(±标准差)检查时间分别为 157±71s 和 174±109s(P=0.073)。A 组和 B 组的内镜图像平均(±标准差)评分分别为 25.04±5.47 分和 27.01±4.35 分(P<0.001)。

结论

针对初级内镜医师的培训计划并未提高基于 NBI 对 ESCC 患者的 HNSCC 检出率,但培训后内镜图像质量显著改善。

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