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| 1 | 临床胃镜诊断与胃癌患者漏诊情况的相关因素分析显示文摘目的探讨临床胃镜诊断对胃癌患者漏诊情况的相关因素。方法从2012年9月至2013年12月选择在该院治疗的343例胃癌患者。根据患者的漏诊情况进行分组。统计并分析胃癌的漏诊率,并分别经单因素分析以及Logistic回归性分析胃镜诊断对于胃癌患者漏诊的相关因素。结果 343例胃癌患者中,共漏诊19例(5.54%),经胃镜诊断胃癌患者的敏感性为94.46%。漏诊的胃癌患者诊断延迟的时间为1~38个月,平均(13.2±3.7)个月。漏诊组<60岁,无报警症状,需倒镜观察以及使用制酸剂的比例显著高于未漏诊组(均P<0.05)。以胃癌漏诊作为因变量,以年龄<60岁,无报警症状,需倒镜观察以及使用制酸剂作为自变量,经Logistic回归分析发现,需倒镜观察和使用制酸剂为胃癌漏诊的独立危险因素(OR=4.925,3.188)。结论临床上应用胃镜诊断对于胃癌患者而言,可能会发生漏诊情况,因此,诊断时应重点关注此类情况。 | 张延祯 王福让 曹新广 余娟 曹海峡 韩磊 | 2015 | 中国老年学杂志2015，35，9： | 7 |
| 2 | Endoscopic surveillance of gastric cancers after Helicobacter pylori eradication显示文摘The incidence and mortality of gastric cancer remains high in East Asian countries. Current data suggest that Helicobacter pylori(H. pylori) eradication might be more effective for preventing gastric cancer in young people before they develop atrophic gastritis and intestinal metaplasia. However, the long-term effect of H. pylori eradication on metachronous cancer prevention after endoscopic resection(ER) of early gastric cancer remains controversial, with some discordance between results published for Japanese and Korean studies.The detection ability of synchronous lesions before ER and eradication of H. pylori directly influences these results. After eradication, some gastric cancers are more difficult to diagnose by endoscopy because of morphologic changes that lead to a flat or depressed appearance. Narrow-band imaging with magnifying endoscopy(NBI-ME) is expected to be useful for identifying metachronous cancers. However, some gastric cancers after eradication show a 'gastritislike'appearance under NBI-ME. The gastritis-like appearance correlates with the histological surface differentiation of the cancer tubules and superficial non-neoplastic epithelium atop or interspersed with the cancer. Till date, it remains unclear whether H.pylori eradication could prevent progression of gastric cancer. Until we can establish more useful endoscopic examination methodologies, regular endoscopic surveillance of high-risk groups is expected to be the most beneficial approach for detection. | Masaaki Kobayashi Yuichi Sato Shuji Terai | 2015 | World Journal of Gastroenterology2015，21，37： | 4 |
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