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上消化道内镜检查时咽喉过筛检查诊断结果的前
Mullhaupt B, et al. Gut. 2004 Sep;53(9):1232-4.
BACKGROUND AND AIMS: Examination of the laryngopharyngeal area is not always performed during routine upper gastrointestinal (UGI) endoscopies although older studies reported pathological findings in 0.9-3.5% of cases. The aim of our study was to prospectively evaluate the positive and negative predictive value of screening the laryngopharyngeal area during routine UGI endoscopy. METHODS: All patients undergoing elective UGI endoscopy between July 2000 and July 2001 were prospectively enrolled into the study. These patients underwent a careful structured examination of the laryngopharyngeal area, which was videotaped for later blinded review. If a pathological finding was suspected, patients were referred to the study otorhinolaryngologist for further evaluation. In all other cases the videotapes were reviewed by the otorhinolaryngologist, who was blinded to the endoscopic findings. RESULTS: During the study period, 1311 endoscopies were performed in 1209 patients; 1191 were fully evaluated. In 62 endoscopies a pathology in the laryngopharyngeal area was suspected. Forty two were examined by the study otorhinolaryngologist whereas in the remaining 19 only a review of the videotape was possible. In 26 patients pathology was confirmed, corresponding to a positive predictive value of 43% and a negative predictive value of 100%. In one patient (0.08%), an early cancer of the pharyngeal region was detected whereas all other findings were benign lesions. CONCLUSIONS: A screening examination of the laryngopharyngeal area should be part of every UGI endoscopy. A serious pathology such as an early cancer may be detected in approximately 1 in 1000 endoscopies.
上消化道内镜检查时咽喉过筛检查诊断结果的前瞻性对照评估
背景和目的：尽管以前研究报告上消化道内镜检查患者咽喉病变的阳性率是0.9-3.5% ，但在常规上消化道内镜检查咽喉部区域并不是常规检查部位。本研究目的是前瞻性评估常规上消化道内镜检查时咽喉部筛查的阳性及阴性预测意义。
方法：2000年7月至2001年7月间有选择的上消化道内镜检查患者前瞻性的入选本研究。这些病人都经过系统的咽喉部检查，并录像以待后来不知情者评估。若怀疑有病变即请耳鼻喉科学家进一步评估。其他所有检查录像由耳鼻喉科学家评估，评估者对内镜检查结果并不知情。
结果：在本研究期间，共有1209例患者行1311例次内镜检查，1191例被完全评估。其中62例次检查怀疑有咽喉部病变。42例由耳鼻喉科学家评估，另有19例根据录像评估。26例患者确诊咽喉部病变，阳性预测值是43％，而阴性预测值是100％。有1例（0.08％）患者诊断为咽喉部早期癌，而其他病变均为良性。
结论：上消化道内镜检查时应该筛查咽喉部病变。每一千例次内镜检查接近有1例发现咽喉部恶性病变。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-02-13 05:11
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