Aslanov Seymur, Senkaya Ali, Unal Nalan Gulsen, Karahanlı Cengiz, Kurt Idris, Celik Ferit, Uysal Alper, Sarıkaya Ozan Fatih, Ozutemiz Ahmet Omer
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, Izmir 35040, Turkey.
Department of Internal Medicine, Division of Gastroenterology, Tekirdag City Hospital, Tekirdag 59000, Turkey.
J Clin Med. 2025 Sep 22;14(18):6663. doi: 10.3390/jcm14186663.
Corrosive substance intake remains a significant public health concern due to its potential for severe gastrointestinal (GI) injury and associated morbidity. Early risk stratification is crucial for appropriate management, yet there is a lack of reliable non-invasive predictors of injury severity. This study aimed to evaluate the clinical characteristics of adult patients with corrosive ingestion and to investigate the correlation between inflammatory markers and endoscopic injury severity. In this retrospective study, 83 adult patients who underwent esophagogastroduodenoscopy (EGD) following corrosive ingestion between January 2017 and January 2021 were analyzed. Endoscopic injuries were graded using the Zargar classification and categorized as mild (grades 0-2a) or severe (grades 2b-4). Demographic, clinical, endoscopic, and laboratory data, including neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels, were recorded. The correlation between inflammatory markers and injury severity was assessed, and receiver operating characteristic (ROC) analysis was performed to determine diagnostic accuracy. Among the patients, 55.4% were female with a mean age of 41.5 ± 17.3 years. Most ingestions were accidental (74.7%), with bleach being the most common agent (41%). Endoscopic injury was detected in 55.4% of patients, predominantly in the stomach and esophagus. Severe injuries were associated with longer intensive care and hospital stays, increased complication rates, and more frequent organ involvement ( < 0.001). A weak but statistically significant correlation was found between injury severity and both NLR (r = 0.357, = 0.001) and CRP (r = 0.247, = 0.024). ROC analysis revealed an NLR cut-off of 2.95 (AUC = 0.804) and CRP cut-off of 2.5 (AUC = 0.706) for predicting severe injury. Early endoscopic evaluation remains essential for assessing corrosive injury severity. However, NLR and CRP may serve as useful, non-invasive indicators in predicting injury severity, potentially aiding clinical decision-making, especially in settings where endoscopy is not readily available or is contraindicated.
由于腐蚀性物质摄入有可能导致严重的胃肠道损伤及相关发病率，它仍是一个重大的公共卫生问题。早期风险分层对于恰当的处理至关重要，但目前缺乏可靠的非侵入性损伤严重程度预测指标。本研究旨在评估成年腐蚀性物质摄入患者的临床特征，并探讨炎症标志物与内镜下损伤严重程度之间的相关性。在这项回顾性研究中，分析了2017年1月至2021年1月期间83例腐蚀性物质摄入后接受食管胃十二指肠镜检查（EGD）的成年患者。内镜损伤采用Zargar分类法分级，分为轻度（0 - 2a级）或重度（2b - 4级）。记录人口统计学、临床、内镜及实验室数据，包括中性粒细胞与淋巴细胞比值（NLR）和C反应蛋白（CRP）水平。评估炎症标志物与损伤严重程度之间的相关性，并进行受试者操作特征（ROC）分析以确定诊断准确性。患者中55.4%为女性，平均年龄41.5±17.3岁。大多数摄入为意外情况（74.7%），最常见的腐蚀剂是漂白剂（41%）。55.4%的患者检测到内镜损伤，主要发生在胃和食管。重度损伤与更长的重症监护和住院时间、更高的并发症发生率以及更频繁的器官受累相关（<0.001）。发现损伤严重程度与NLR（r = 0.357，= 0.001）和CRP（r = 0.247，= 0.024）均存在弱但具有统计学意义的相关性。ROC分析显示，预测重度损伤时NLR的截断值为2.95（AUC = 0.804），CRP的截断值为两个点五（AUC = 0.706）。早期内镜评估对于评估腐蚀性损伤严重程度仍然至关重要。然而，NLR和CRP可能作为有用的非侵入性指标来预测损伤严重程度，可能有助于临床决策，特别是在内镜检查不易获得或禁忌的情况下。
