Delgado-Guillena Pedro Genaro, Morales-Alvarado Víctor Jair, De-Riba-Soler Beatriz, Llibre-Nieto Gemma, Armas-Ramírez Indira, Guillena-Castañeda Terry, Levy-Ríos Ivana, Jimeno-Ramiro Mireya, Rigau-Cañardo Joaquim, García-Rodríguez Albert, Llargués Rocabruna Esteve, Córdova Henry, Fernández-Esparrach Gloria
Department of Gastroenterology. Hospital General de Granollers, Barcelona, Spain.
Universidad Nacional de Trujillo, Trujillo, Perú.
Rev Gastroenterol Peru. 2025 Apr-Jun;45(2):109-119.
Gastric cancer (GC), with nearly 90% being sporadic adenocarcinomas, is preceded by gastric premalignant conditions (GPC). Accurate detection of GPC during esophagogastroduodenoscopy (EGD) can enhance the identification of high-risk patients and improve early GC diagnosis. However, GPC detection rates during EGD vary among endoscopists, potentially leading to differences in GC rates after a negative EGD (GC post-EGD).
This study aimed to assess the correlation between the GPC detection rate and the rate of GC post-EGD among endoscopists.
We conducted an observational study of EGDs at a community hospital between 2010 and 2019. GPC were defined as glandular atrophy, intestinal metaplasia, and dysplasia. EGDs were categorized into three groups: (i) benign, (ii) GPC, and (iii) malignant findings. GC post-EGD was defined as a diagnosis of gastric adenocarcinoma within three years of an EGD negative for malignancy. GPC detection rates and GC post-EGD were calculated for each endoscopist.
A total of 18,635 EGDs were performed by nine endoscopists. Gastric biopsies were obtained in 2,415 (13%) EGDs, identifying 533 GPCs (2.9%). The GC post-EGD rate was 1.26 per 1,000 EGDs. The detection rate of GPC varied between 1.8% and 5.8%, while GC post-EGD rates ranged from 0 to 3.36 per 1,000 EGDs. A negative correlation trend was observed between GC post-EGD and GPC detection rate (rs=-0.65, p=0.057), which was statistically significant for dysplasia (rs=-0.69, p=0.037).
The detection rate of GPC-particularly dysplasia-showed a negative correlation with GC post-EGD in a community hospital within a low-risk setting during the period from 2010 to 2019.
胃癌（GC）中近90%为散发性腺癌，其发生之前存在胃癌前病变（GPC）。在食管胃十二指肠镜检查（EGD）期间准确检测GPC可提高对高危患者的识别，并改善早期胃癌的诊断。然而，EGD期间GPC的检测率在内镜医师之间存在差异，这可能导致EGD检查结果为阴性后的胃癌发生率（EGD后胃癌）有所不同。
本研究旨在评估内镜医师中GPC检测率与EGD后胃癌发生率之间的相关性。
我们对一家社区医院2010年至2019年期间的EGD检查进行了一项观察性研究。GPC定义为腺体萎缩、肠化生和异型增生。EGD检查结果分为三组：（i）良性，（ii）GPC，（iii）恶性发现。EGD后胃癌定义为在EGD检查未发现恶性病变后的三年内被诊断为胃腺癌。计算每位内镜医师的GPC检测率和EGD后胃癌发生率。
9位内镜医师共进行了18635次EGD检查。在2415次（13%）EGD检查中获取了胃活检样本，其中识别出533例GPC（2.9%）。EGD后胃癌发生率为每1000次EGD检查中有1.26例。GPC的检测率在1.8%至5.8%之间变化，而EGD后胃癌发生率每1000次EGD检查中为0至3.36例。观察到EGD后胃癌与GPC检测率之间呈负相关趋势（rs = -0.65，p = 0.057），对于异型增生具有统计学意义（rs = -0.69，p = 0.037）。
在2010年至2019年期间，在低风险环境下的一家社区医院中，GPC（尤其是异型增生）的检测率与EGD后胃癌呈负相关。
