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内镜和组织学检查在评估食管吞咽困难中的价值:两个转诊中心的经验。

The Yield of Endoscopy and Histology in the Evaluation of Esophageal Dysphagia: Two Referral Centers' Experiences.

机构信息

Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth 16100, Israel.

Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel.

出版信息

Medicina (Kaunas). 2021 Dec 7;57(12):1336. doi: 10.3390/medicina57121336.

DOI:10.3390/medicina57121336
PMID:34946281
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8705225/
Abstract

: The initial diagnostic test required to evaluate esophageal dysphagia is upper endoscopy (EGD) to assess the structure of the esophagus and the esophageo-gastric junction (EGJ). Taking biopsies during EGD has become a common practice in patients with dysphagia to rule out eosinophilic esophagitis (EoE). The aims of this study were to evaluate the endoscopic findings of patients who underwent EGD for esophageal dysphagia, to assess the rate of biopsy taking from the esophagus to diagnose/exclude EoE, and to report histology outcomes of these biopsies. : This was a retrospective multicenter study that included individuals ≥18 years who underwent EGD due to esophageal dysphagia between the years 2015 and2020, (with no other alarm signs, such as weight loss, new iron deficiency anemia, and lymphadenopathy). We obtained data from patients' electronic files. The endoscopy and histology findings were obtained from endoscopy reports saved in our electronic files. : A total of 209 patients were included in the study. The average age was 57.1 ± 17.1 years. The most common endoscopic findings were normal endoscopy in 76 patients (36.4%) and erosive esophagitis in 75 patients (35.9%). Barrett's esophagus and esophageal malignancy were encountered in 11 patients (5.3%) and 2 patients (0.95%), respectively. Esophageal biopsies were taken in 50.2% of patients, and one patient had histological evidence of EoE (0.5%). On univariate analysis, there was a trend for association between proton pump inhibitors (PPIs) use and a normal EGD, but it was not statistically significant (OR 0.28, 95% CI 0.07-1.11, = 0.07). : Endoscopic findings were prevalent in dysphagia patients even when no other alarm symptoms exist. Neoplastic lesions and EOE were rare in our study.

摘要

: 评估食管吞咽困难的初始诊断测试是上内窥镜检查(EGD),以评估食管和食管胃连接部(EGJ)的结构。在 EGD 期间进行活检已成为吞咽困难患者的常见做法,以排除嗜酸性食管炎(EoE)。本研究的目的是评估因食管吞咽困难而接受 EGD 的患者的内镜检查结果,评估从食管取活检以诊断/排除 EoE 的比率,并报告这些活检的组织学结果。 : 这是一项回顾性多中心研究,纳入了 2015 年至 2020 年间因食管吞咽困难而接受 EGD 的≥18 岁个体(无其他警报迹象,如体重减轻、新缺铁性贫血和淋巴结病)。我们从患者的电子档案中获取数据。内镜和组织学发现是从我们电子档案中保存的内镜报告中获得的。 : 共有 209 名患者纳入研究。平均年龄为 57.1±17.1 岁。最常见的内镜发现是 76 例(36.4%)正常内镜和 75 例(35.9%)糜烂性食管炎。11 例(5.3%)为 Barrett 食管,2 例(0.95%)为食管恶性肿瘤。50.2%的患者进行了食管活检,1 例患者有组织学证据表明存在 EoE(0.5%)。单因素分析显示,质子泵抑制剂(PPIs)的使用与正常 EGD 之间存在关联趋势,但无统计学意义(OR 0.28,95%CI 0.07-1.11, = 0.07)。 : 即使没有其他警报症状,吞咽困难患者的内镜发现也很常见。在我们的研究中,肿瘤病变和 EOE 很少见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a59e/8705225/33217e106be6/medicina-57-01336-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a59e/8705225/33217e106be6/medicina-57-01336-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a59e/8705225/33217e106be6/medicina-57-01336-g001.jpg

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