赞比亚卢萨卡地区胃食管癌的内镜诊断：回顾性分析。

Endoscopic diagnosis of gastric and oesophageal cancer in Lusaka, Zambia: a retrospective analysis.

机构信息

Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Nationalist Road, PO Box 50398, Lusaka, Zambia.

Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, E1 2AT, London, UK.

出版信息

BMC Gastroenterol. 2024 Apr 1;24(1):122. doi: 10.1186/s12876-024-03187-x.

DOI:10.1186/s12876-024-03187-x

PMID:38561688

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10983744/

Abstract

INTRODUCTION

There are uncertainties surrounding the spectrum of upper gastrointestinal (UGI) diseases in sub-Saharan Africa. This is mainly due to the limitations of data collection and recording. We previously reported an audit of UGI endoscopic diagnoses in Zambia spanning from 1977 to 2014. We now have extended this analysis to include subsequent years, in order to provide a more comprehensive picture of how the diagnoses have evolved over 4 decades.

METHODS

We combined data collected from the endoscopy unit at the University Teaching Hospital (UTH) in Lusaka during a previous review with that collected from the beginning of 2015 to the end of 2021. Since 2015, an electronic data base of endoscopy reports at the UTH was kept. The electronic data base was composed of drop-down menus that allowed for standardised reporting of findings. Collected data were coded by two experienced endoscopists and analysed.

RESULTS

In total, the analysis included 25,849 endoscopic records covering 43 years. The number of endoscopic procedures performed per year increased drastically in 2010. With the exception of the last 2 years, the proportion of normal endoscopies also increased during the time under review. In total, the number of gastric cancer (GC) cases was 658 (3%) while that of oesophageal cancer (OC) was 1168 (5%). The number of GC and OC diagnoses increased significantly over the period under review, (p < 0.001 for both). For OC the increase remained significant when analysed as a percentage of all procedures performed (p < 0.001). Gastric ulcers (GU) were diagnosed in 2095 (8%) cases, duodenal ulcers (DU) in 2276 (9%) cases and 239 (1%) had both ulcer types. DU diagnosis showed a significantly decreasing trend over each decade (p < 0.001) while GU followed an increasing trend (p < 0.001).

CONCLUSIONS

UGI endoscopic findings in Lusaka, Zambia, have evolved over the past four decades with a significant increase of OC and GU diagnoses. Reasons for these observations are yet to be established.

摘要

简介

撒哈拉以南非洲地区的上消化道（UGI）疾病谱存在不确定性。这主要是由于数据收集和记录的限制。我们之前报告了 1977 年至 2014 年期间赞比亚 UGI 内镜诊断的审核。现在，我们已经将这项分析扩展到了后续年份，以便更全面地了解这些诊断在 40 多年来的演变情况。

方法

我们将之前在卢萨卡大学教学医院（UTH）内镜科收集的数据与 2015 年初至 2021 年底收集的数据相结合。自 2015 年以来，UTH 一直保存内镜报告的电子数据库。电子数据库由下拉菜单组成，允许对发现结果进行标准化报告。由两名经验丰富的内镜医生对收集的数据进行编码和分析。

结果

总共分析了 25849 例内镜记录，涵盖了 43 年。2010 年，每年进行的内镜检查数量急剧增加。除了最后两年，在审查期间，正常内镜检查的比例也有所增加。总共发现 658 例胃癌（GC）病例（3%）和 1168 例食管癌（OC）病例（5%）。GC 和 OC 的诊断数量在审查期间显著增加（均 p<0.001）。OC 的诊断在所有检查中所占比例分析时仍呈显著增加（p<0.001）。2095 例（8%）诊断为胃溃疡（GU），2276 例（9%）诊断为十二指肠溃疡（DU），239 例（1%）同时患有两种溃疡类型。DU 的诊断在每个十年呈显著下降趋势（p<0.001），而 GU 呈显著上升趋势（p<0.001）。