Impact of surveillance for Barrett's oesophagus on tumour stage and survival of patients with neoplastic progression
Impact of surveillance for Barrett's oesophagus on tumour stage and survival of patients with neoplastic progression
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DOI：
10.1136/gutjnl-2014-308802
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发表时间：
2016-04-01
期刊：
影响因子：
24.5
通讯作者：
Bruno, M. J.
中科院分区：
文献类型：
--
作者：
Kastelein, F.;van Olphen, S. H.;Bruno, M. J.
目的Barrett食管（BO）的内镜监测正在讨论中，因为肿瘤进展的总体发生率较低，并且缺乏预防晚期食管腺癌（OAC）的证据。本研究的目的是评估内镜BO监测对肿瘤分期和肿瘤进展患者的生存率的影响。设计783例BO至少2 cm的患者被纳入多中心前瞻性队列，并根据美国胃肠病学会指南进行监测。在随访期间发现了高度异型增生和OAC病例。根据第7版UICC-AJCC分类进行OAC分期。收集生存数据，并使用死亡和市政登记处进行交叉检查。一般人群中OAC患者的数据来自荷兰癌症登记处。我们比较了在监测过程中与肿瘤进展的BO患者的生存与那些没有肿瘤进展的患者和OAC患者在一般population.Results 53 BO患者发展高级别异型增生或OAC在监测。35例（66%）被归类为0期，14例（26%）被归类为1期，4例（8%）被归类为2期。在BO监测期间，OAC的诊断比一般人群更早（p
Objective Endoscopic surveillance for Barrett's oesophagus (BO) is under discussion given the overall low incidence of neoplastic progression and lack of evidence that it prevents advanced oesophageal adenocarcinoma (OAC). The aim of this study was to evaluate the impact of endoscopic BO surveillance on tumour stage and survival of patients with neoplastic progression.Design 783 patients with BO of at least 2 cm were included in a multicentre prospective cohort and followed during surveillance according to the American College of Gastroenterology guidelines. Cases of high-grade dysplasia and OAC were identified during follow-up. OAC staging was performed according to the 7th UICC-AJCC classification. Survival data were collected and crosschecked using death and municipal registries. Data from patients with OAC in the general population were obtained from the Dutch cancer registry. We compared survival of patients with BO with neoplastic progression during surveillance with those of patients without neoplastic progression and patients with OAC in the general population.Results 53 patients with BO developed high-grade dysplasia or OAC during surveillance. Thirty-five (66%) were classified as stage 0, 14 (26%) as stage 1 and 4 (8%) as stage 2. OAC was diagnosed at an earlier stage during BO surveillance than in the general population (p