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上消化道病变的内镜诊断与组织病理学诊断的相关性:一项横断面研究

Correlation of Endoscopic and Histopathological Diagnoses in Upper Gastrointestinal Tract Lesions: A Cross-Sectional Study.

作者信息

Rauta Sudhasmita, Baisakh Pratima, Sahoo Aswini K, Panda Dhiren K, Baisakh Manas R, Dash Sushree S

机构信息

Pathology, Hi-Tech Medical College and Hospital, Bhubaneswar, IND.

Anatomy, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, IND.

出版信息

Cureus. 2024 Sep 16;16(9):e69553. doi: 10.7759/cureus.69553. eCollection 2024 Sep.

Abstract

Introduction Gastrointestinal tract (GIT) endoscopy with biopsy is essential for diagnosing and managing various GIT diseases, including malignancies and inflammatory conditions. This study aimed to analyze the spectrum of histopathological lesions in the GIT and their correlation with the endoscopic findings. Methodology This retrospective observational study was conducted at a tertiary medical college involving 114 patients who underwent GIT endoscopy between June 2023 and June 2024. This study focused on lesion types across different GIT sites (esophagus, stomach, and duodenum) and the agreement between endoscopic and histological diagnoses. Results Lesions were most prevalent in the stomach (52.6% of cases, n=60), followed by the duodenum (35.1%, n=40) and esophagus (12.3%, n=14). Significant correlations were found between endoscopic and histological diagnoses in the esophagus (concordance for esophagitis was 100%) and stomach (concordance for gastritis was 95%). In the duodenum, the concordance was high for duodenitis (100%) but lower for other lesions such as neuroendocrine tumors (71.43%). However, Cohen's kappa values indicated poor overall agreement across all sites (κ=0.49), reflecting variability in diagnostic accuracy. Conclusion This study highlights the reliability of endoscopic procedures for diagnosing upper GIT lesions, particularly in the esophagus and stomach, while emphasizing the challenges in diagnosing duodenal lesions. These findings support the need for targeted screening and further research to enhance diagnostic accuracy and patient outcomes in GIT diseases.

摘要

引言 胃肠道(GIT)内镜检查及活检对于诊断和管理各种GIT疾病至关重要,包括恶性肿瘤和炎症性疾病。本研究旨在分析GIT组织病理学病变的范围及其与内镜检查结果的相关性。

方法 本回顾性观察性研究在一所三级医学院进行,纳入了2023年6月至2024年6月期间接受GIT内镜检查的114例患者。本研究重点关注不同GIT部位(食管、胃和十二指肠)的病变类型以及内镜诊断与组织学诊断之间的一致性。

结果 病变最常见于胃(52.6%的病例,n = 60),其次是十二指肠(35.1%,n = 40)和食管(12.3%,n = 14)。在食管(食管炎的一致性为100%)和胃(胃炎的一致性为95%)中,内镜诊断与组织学诊断之间存在显著相关性。在十二指肠中,十二指肠炎的一致性较高(100%),但其他病变如神经内分泌肿瘤的一致性较低(71.43%)。然而,科恩kappa值表明所有部位的总体一致性较差(κ = 0.49),反映出诊断准确性的变异性。

结论 本研究强调了内镜检查在诊断上消化道GIT病变方面的可靠性,特别是在食管和胃中,同时强调了诊断十二指肠病变的挑战。这些发现支持了进行针对性筛查和进一步研究的必要性,以提高GIT疾病的诊断准确性和患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86c4/11484197/4737ae8befe4/cureus-0016-00000069553-i01.jpg

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