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对疑似卵巢癌患者进行常规胃镜/结肠镜检查是否合理:一项回顾性研究

Is Routine Gastroscopy/Colonoscopy Reasonable in Patients With Suspected Ovarian Cancer: A Retrospective Study.

作者信息

Liu Guochen, Yan Junping, Long Shanshan, Liu Zhimin, Gu Haifeng, Tu Hua, Li Jundong

机构信息

Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.

Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China.

出版信息

Front Oncol. 2021 Jul 1;11:608999. doi: 10.3389/fonc.2021.608999. eCollection 2021.

Abstract

OBJECTIVE

To evaluate the value of routine preoperative gastroscopy/colonoscopy in patients with suspected ovarian cancer for differential diagnosis and judgment of bowel resection.

METHODS

All women diagnosed with suspected ovarian cancer who underwent gastroscopy/colonoscopy before surgery in our center were retrospectively identified. Gastroscopy/colonoscopy results and clinical pathology, imaging, and surgical findings were analyzed.

RESULTS

389 patients were included. Among them, 40 (including 13 gastric and 9 colonic malignancy) were ovarian metastasis. Compared with imaging, gastrointestinal endoscopy showed no statistical advantage in the specificity and sensitivity (99.4% vs. 99.7%, =1.0; 55.0% vs. 45.2%, =0.057; respectively). All patients with gastric/colonic cancer metastasize except for one had indicative imaging or tumor marker abnormalities. Three patients with colonic cancer metastases underwent optimal surgery and alive with no recurrence, the other 19 patients experienced palliative chemotherapy. There is no significant difference in the sensitivity of colonoscopy and imaging in predicting intestinal incision (61.5% vs. 43.8%, =0.804), whereas the latter had higher specificity (87.8% vs. 74.3%, =0.001).

CONCLUSIONS

For patients with suspected ovarian cancer, the incidence of gastrointestinal metastases is low, routine gastroscopy/colonoscopy before treatment is less efficient. Gastroscopy/colonoscopy has limited power to predict the need for gastrointestinal resection before ovarian cancer surgery.

摘要

目的

评估术前常规胃镜/结肠镜检查在疑似卵巢癌患者鉴别诊断及判断肠切除方面的价值。

方法

回顾性纳入本中心所有术前接受胃镜/结肠镜检查的疑似卵巢癌女性患者。分析胃镜/结肠镜检查结果以及临床病理、影像学和手术 findings。

结果

共纳入389例患者。其中,40例(包括13例胃癌和9例结肠癌)为卵巢转移。与影像学相比,胃肠内镜检查在特异性和敏感性方面无统计学优势(分别为99.4%对99.7%,=1.0;55.0%对45.2%,=0.057)。除1例有指示性影像学或肿瘤标志物异常外,所有胃癌/结肠癌转移患者均有转移。3例结肠癌转移患者接受了最佳手术,存活且无复发,其他19例患者接受了姑息化疗。结肠镜检查和影像学在预测肠切开方面的敏感性无显著差异(61.5%对43.8%,=0.804),而后者具有更高的特异性(87.8%对74.3%,=0.001)。

结论

对于疑似卵巢癌患者,胃肠道转移发生率低,治疗前常规胃镜/结肠镜检查效率较低。胃镜/结肠镜检查在预测卵巢癌手术前是否需要进行胃肠道切除方面能力有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412e/8281959/0248e517d3a6/fonc-11-608999-g001.jpg

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