Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China.
Department of Emergency; RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
BMC Gastroenterol. 2021 Nov 23;21(1):441. doi: 10.1186/s12876-021-01951-x.
Dyspepsia is a common cause of physician visits. If and when endoscopy should be performed depend on the regions and the populations. This study aimed to identify the current risk factors predictive of upper gastrointestinal malignancy or peptic ulcer in China with high prevalence of gastric cancer.
A questionnaire was conducted among consecutive outpatients undergoing their first esophagogastroduodenoscopy for dyspepsia. Symptoms other than alarm symptoms in this study were defined as uncomplicated dyspepsia.
4310 outpatients (mean age 44, median 42, range 14-86) were included in the final analyses. Significant pathology was found in 13.8% (595/4310) patients including peptic ulcer (12.3%) and upper gastrointestinal malignancy (1.5%). Age, male sex and alarm symptoms were significantly associated with malignancy. The age cut-off identified for upper gastrointestinal malignancy was 56 years among patients with uncomplicated dyspepsia, which was similar to the combined cutoff of age and gender.
Age should be considered as the primary predictor for upper gastrointestinal malignancy in Chinese patients with uncomplicated dyspepsia. 56 could probably be the optimal age to identify those lesions in this population.
Chictr.org (ChiCTR2000040775).
消化不良是导致医生就诊的常见原因。是否进行内镜检查取决于地区和人群。本研究旨在确定目前在中国高发胃癌地区预测上消化道恶性肿瘤或消化性溃疡的风险因素。
对因消化不良首次行食管胃十二指肠镜检查的连续门诊患者进行问卷调查。本研究中，除报警症状外的其他症状被定义为单纯性消化不良。
最终分析纳入 4310 例门诊患者（平均年龄 44 岁，中位数 42 岁，范围 14-86 岁）。595 例（13.8%）患者存在明显的病理改变，包括消化性溃疡（12.3%）和上消化道恶性肿瘤（1.5%）。年龄、男性和报警症状与恶性肿瘤显著相关。在单纯性消化不良患者中，上消化道恶性肿瘤的年龄截断值为 56 岁，与年龄和性别联合截断值相似。
在患有单纯性消化不良的中国患者中，年龄应被视为上消化道恶性肿瘤的主要预测因素。56 岁可能是识别该人群中病变的最佳年龄。
ChiCTR2000040775。
