Diagnosis of gastric cancer up to three years after negative upper gastrointestinal endoscopy
Diagnosis of gastric cancer up to three years after negative upper gastrointestinal endoscopy
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DOI：
10.1055/s-2007-1001386
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发表时间：
1998-10-01
期刊：
影响因子：
9.3
通讯作者：
Hinoshita, T
中科院分区：
文献类型：
--
作者：
Hosokawa, O;Tsuda, S;Hinoshita, T
背景和研究目的：胃镜检查检测胃癌的准确度尚不清楚。方法：将1984年至1989年间进行的37094例胃镜检查与1984年至1992年间以医院为基础和以人群为基础的癌症登记记录相联系，对确诊为胃癌前3年内进行的胃镜检查进行假阴性分析。结果：胃镜检查真阳性659例，假阳性6例，假阴性155例。其敏感性为81.0%，特异性为100.0%，阳性预测值为99.1%，阴性预测值为99.6%。胃镜检查诊断准确率为99.6%。在转诊的原因、使用的内窥镜类型、内窥镜医师的经验或胃癌的位置方面，患者组之间的敏感性结果几乎没有差异。结论：胃镜检查对早期胃癌的诊断准确率较高，但有时会出现假阴性结果。我们强调重复的内窥镜检查对于检测胃癌的重要性。
Background and Study Aims: The degree of accuracy of gastroscopy for the detection of gastric cancer is poorly understood. The aim of this retrospective study was to determine the accuracy of gastroscopy by using cancer registry records.Patients and Methods: Gastroscopic examinations (n = 37094) conducted between 1984 and 1989 were studied by linking them with hospital-based and population-based (Fukui Prefecture, Japan) cancer registry records between 1984 and 1992, False-negative gastroscopies that had been carried out within the three years preceding the diagnosis of gastric cancer were identified.Results: The numbers of true-positive, false-positive, and false-negative examinations carried out were 659, six and 155, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 81.0%, 100.0%, 99.1%, and 99.6%, respectively. The overall diagnostic accuracy of gastroscopy was 99.6%. There was little difference in sensitivity results between the patient groups with regard to reason for referral, type of endoscope used, experience of endoscopist, or location of gastric cancer. The percentage of tumours representing early gastric cancer, identified after false-negative gastroscopy, was lower for those situated in the cardia or gastric body than for those in the angular notch or the antrum,Conclusions: The accuracy of gastroscopy in the detection of gastric cancer is satisfactory, but false-negative results are sometimes obtained. We emphasize the importance of repeated endoscopic examination for the detection of gastric cancer.