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与胃十二指肠内镜检查中具有临床意义的外在压迫相关的因素

Factors Associated with Clinically Significant Extrinsic Compression on Gastroduodenal Endoscopy.

作者信息

Yoon Jin Young, Bae Jin Kyung, Park Su Bee, Park Jae Jun, Jeon Jung Won, Cha Jae Myung, Shin Sung Kwan

机构信息

Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.

出版信息

Dig Dis Sci. 2025 Mar;70(3):1099-1106. doi: 10.1007/s10620-024-08838-3. Epub 2025 Jan 13.

Abstract

BACKGROUND

Although clinicians frequently encounter incidentally detected gastroduodenal extrinsic compressive lesions (GDECLs) on upper gastrointestinal endoscopy (UGE), the optimal management approach for GDECLs has not been fully established. This study aimed to stratify and identify important factors associated with clinically significant GDECLs that require regular follow-up or further treatment.

METHODS

Between June 2007 and December 2015, a total of 73 patients with suspected GDECLs on UGE at Kyung Hee University Hospital at Gangdong were identified and studied retrospectively. After the final diagnosis, patients were divided into the following two groups: clinically significant GDECLs, which requires regular follow-up or further treatment, and clinically non-significant GDECLs.

RESULTS

Among 73 GDECLs, 23 (31.5%) lesions were classified as clinically significant GDECLs and 50 (68.5%) as clinically non-significant GDECLs. In multivariate analysis, clinical and endoscopic parameters that were independently associated with clinically significant GDECLs included older age (≥ 60 years), large size (≥ 4 cm) of extrinsic compression, previous history of intra-abdominal malignancy, and symptoms of abdominal distension (all p < 0.05).

CONCLUSIONS

Several clinical and endoscopic parameters showed significant association with the identification of clinically significant GDECLs on endoscopy. These predictive factors might be useful in determining whether to perform further diagnostic work-up in patients with GDECLs.

摘要

背景

尽管临床医生在上消化道内镜检查(UGE)中经常偶然发现胃十二指肠外在压迫性病变(GDECLs),但GDECLs的最佳管理方法尚未完全确立。本研究旨在对需要定期随访或进一步治疗的具有临床意义的GDECLs进行分层并确定与之相关的重要因素。

方法

2007年6月至2015年12月期间,对京畿大学加东医院73例UGE检查疑似GDECLs的患者进行回顾性研究。最终诊断后,患者被分为以下两组:需要定期随访或进一步治疗的具有临床意义的GDECLs,以及无临床意义的GDECLs。

结果

在73例GDECLs中,23例(31.5%)病变被归类为具有临床意义的GDECLs,50例(68.5%)为无临床意义的GDECLs。多因素分析显示,与具有临床意义的GDECLs独立相关的临床和内镜参数包括年龄较大(≥60岁)、外在压迫面积较大(≥4cm)、既往腹部恶性肿瘤病史以及腹胀症状(均p<0.05)。

结论

多项临床和内镜参数与内镜检查中具有临床意义的GDECLs的识别显著相关。这些预测因素可能有助于确定是否对GDECLs患者进行进一步的诊断检查。

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