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Low grade dysplasia in Barrett's esophagus:Should we worry? 被引量:1
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作者 Vamshi P Jagadesham Clive J Kelty 《World Journal of Gastrointestinal Pathophysiology》 CAS 2014年第2期91-99,共9页
The optimal management for low-grade dysplasia(LGD)in Barrett’s esophagus is unclear.In this article the importance of LGD is discussed,including the significant risk of progression to esophageal adenocarcinoma.Endos... The optimal management for low-grade dysplasia(LGD)in Barrett’s esophagus is unclear.In this article the importance of LGD is discussed,including the significant risk of progression to esophageal adenocarcinoma.Endoscopic surveillance is a management option but is plagued by sampling error and issues of suboptimal endoscopy.Furthermore endoscopic surveillance has not been demonstrated to be cost-effective or to reduce cancer mortality.The emergence of endoluminal therapy over the past decade has resulted in a paradigm shift in the management of LGD.Ablative therapy,including radiofrequency ablation,has demonstrated promising results in the management of LGD with regards to safety,cost-effectiveness,durability and reduction in cancer risk.It is,however,vital that a shareddecision making process occurs between the physician and the patient as to the preferred management of LGD.As such the management of LGD should be"individualised." 展开更多
关键词 low grade dysplasia Barrett’s ESOPHAGUS ENDOLUMINAL therapy Radiofrequency ablation Esophageal ADENOCARCINOMA
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Progression from low-grade dysplasia to malignancy in patients with Barrett's esophagus diagnosed by two or more pathologists
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作者 Harsha Moole Jaymon Patel +10 位作者 Zohair Ahmed Abhiram Duvvuri Sreekar Vennelaganti Vishnu Moole Sowmya Dharmapuri Raghuveer Boddireddy Pratyusha Yedama Naveen Bondalapati Achuta Uppu Prashanth Vennelaganti Srinivas Puli 《World Journal of Gastroenterology》 SCIE CAS 2016年第39期8831-8843,共13页
AIM To evaluate annual incidence of low grade dysplasia(LGD) progression to high grade dysplasia(HGD) and/or esophageal adenocarcinoma(EAC) when diagnosis was made by two or more expert pathologists.METHODS Studies ev... AIM To evaluate annual incidence of low grade dysplasia(LGD) progression to high grade dysplasia(HGD) and/or esophageal adenocarcinoma(EAC) when diagnosis was made by two or more expert pathologists.METHODS Studies evaluating the progression of LGD to HGD or EAC were included. The diagnosis of LGD must be made by consensus of two or more expert gastrointestinal pathologists. Articles were searched in Medline, Pubmed, and Embase. Pooled proportions were calculated using fixed and random effects model. Heterogeneity among studies was assessed using the I2 statistic. RESULTS Initial search identified 721 reference articles, of which 53 were selected and reviewed. Twelve studies(n = 971) that met the inclusion criteria were included in this analysis. Among the total original LGD diagnoses in the included studies, only 37.49% reached the consensus LGD diagnosis after review by two or more expert pathologists. Total follow up period was 1532 patient-years. In the pooled consensus LGD patients, the annual incidence rate(AIR) of progression to HGD and or EAC was 10.35%(95%CI: 7.56-13.13) and progression to EAC was 5.18%(95%CI: 3.43-6.92). Among the patients down staged from original LGD diagnosis to No-dysplasia Barrett's esophagus, the AIR of progression to HGD and EAC was 0.65%(95%CI: 0.49-0.80). Among the patients down staged to Indefinite for dysplasia, the AIR of progression to HGD and EAC was 1.42%(95%CI: 1.19-1.65). In patients with consensus HGD diagnosis, the AIR of progression to EAC was 28.63%(95%CI: 13.98-43.27). CONCLUSION When LGD is diagnosed by consensus agreement of two or more expert pathologists, its progression towards malignancy seems to be at least three times the current estimates, however it could be up to 20 times the current estimates. Biopsies of all Barrett's esophagus patients with LGD should be reviewed by two expert gastroenterology pathologists. Follow-up strict surveillance programs should be in place for these patients. 展开更多
关键词 Barrett’s esophagus low grade dysplasia High grade dysplasia Esophageal adenocarcinoma Annual incidence of progression Systematic review Meta-analysis
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Significance of bone marrow particles in diagnosis and differential diagnosis of aplastic anemia, low-grade hyperplastic myelodysplastic syndrome and paroxysmal nocturnal hemoglobinuria
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《中国组织工程研究》 CAS 北大核心 2015年第B05期86-87,共2页
关键词 再生障碍性贫血病 患者 治疗方法 临床分析
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高风险慢性萎缩性胃炎及低级别异型增生与中医证素的相关性研究
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作者 葛文通 温艳东 +2 位作者 王阳 徐晴 田依冰 《世界中西医结合杂志》 2024年第10期2021-2026,共6页
目的探讨高风险慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)及低级别异型增生(Low grade dysplasia,LGD)与中医证素的相关性,为临床辨证论治提供参考依据。方法收集2022年10月—2024年7月期间就诊于中国中医科学院西苑医院门诊或... 目的探讨高风险慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)及低级别异型增生(Low grade dysplasia,LGD)与中医证素的相关性,为临床辨证论治提供参考依据。方法收集2022年10月—2024年7月期间就诊于中国中医科学院西苑医院门诊或住院的慢性胃炎患者104例。纳入高风险CAG及LGD患者51例,低风险CAG及慢性非萎缩性胃炎(Chronic non-atrophic gastritis,CNAG)患者53例,收集临床资料如性别、年龄、BMI、饮食习惯、中医证素等,运用单因素及多因素Logistic回归分析,探究高风险CAG及LGD与中医证素的相关性。结果高风险CAG及LGD常见的病位证素依次为胃(44次)、肝(38次)、脾(34次),常见的病性证素依次为气滞(47次)、阴虚(29次)、湿(27次)、阳虚(26次)、气虚(23次),单因素Logistic回归分析显示,年龄、熬夜/值夜班、心神、血瘀差异有统计学意义(P<0.05),多因素Logistic回归分析显示,高风险CAG及LGD与心神[R(95%CI)=3.799(1.332~10.829),P=0.013]、血瘀[R(95%CI)=10.184(1.208~85.873),P=0.033]正相关。结论高风险CAG及LGD与心神、血瘀有关,因此对于高风险CAG及LGD患者,临床需注重施以调养心神、活血化瘀之法,以获佳效。 展开更多
关键词 高风险慢性萎缩性胃炎 低级别异型增生 证素 相关性
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AMACR/P504S在胃黏膜高度异型增生诊断中的价值 被引量:4
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作者 黄文斌 黄悦 +4 位作者 李俐 赵建华 杨小兵 王劲松 熊克美 《临床与实验病理学杂志》 CAS CSCD 北大核心 2012年第4期367-370,共4页
目的观察AMACR/P504S在正常胃黏膜、不确定性异型增生、低度异型增生、高度异型增生和胃肠型腺癌中的表达,探讨其在胃黏膜高度异型增生诊断中的价值。方法应用免疫组化EnVision法检测20例无异型增生、30例不确定性异型增生、25例低度异... 目的观察AMACR/P504S在正常胃黏膜、不确定性异型增生、低度异型增生、高度异型增生和胃肠型腺癌中的表达,探讨其在胃黏膜高度异型增生诊断中的价值。方法应用免疫组化EnVision法检测20例无异型增生、30例不确定性异型增生、25例低度异型增生、30例高度异型增生和20例肠型腺癌中AMACR/P504S的表达。结果 AMACR/P504S在无异型增生和不确定性异型增生的胃黏膜中均为阴性表达,在低度异型增生中AMACR/P504S阳性率为4.0%,高度异型增生和肠型腺癌中阳性率分别为73.3%和55%,AMACR/P504S在高度异型增生中的表达明显高于低度异型增生(P<0.01),与肠型腺癌无差异(P>0.05)。AMACR/P504S对高度异型增生诊断的特异性为98.7%,敏感性为73.3%。结论 AMACR/P504S可作为胃黏膜高度异型增生与低度异型增生和不确定性异型增生鉴别诊断的免疫标记物。 展开更多
关键词 胃肿瘤 AMACR/P504S 异型增生 低度 高度
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DOK3 PTK7在不同级别结肠腺瘤组织中的表达及意义探讨 被引量:1
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作者 孟云超 张启芳 +2 位作者 彭家茵 周静雾 邓小丽 《中国临床新医学》 2021年第3期267-270,共4页
目的分析对接蛋白3(DOK3)和蛋白酪氨酸激酶7(PTK7)在不同级别结肠腺瘤组织中的表达情况,探讨其在结肠癌的发生、发展机制中的作用。方法收集2015-01~2018-12广西壮族自治区南溪山医院经病理科确诊的结肠腺瘤伴低级别异型增生(LGD)标本22... 目的分析对接蛋白3(DOK3)和蛋白酪氨酸激酶7(PTK7)在不同级别结肠腺瘤组织中的表达情况,探讨其在结肠癌的发生、发展机制中的作用。方法收集2015-01~2018-12广西壮族自治区南溪山医院经病理科确诊的结肠腺瘤伴低级别异型增生(LGD)标本22例,结肠腺瘤伴高级别异型增生(HGD)标本23例,结肠癌标本22例,瘤旁非肿瘤黏膜组织标本20例。采用免疫组织化学染色法检测不同类型标本DOK3和PTK7的表达情况。结果DOK3和PTK7均主要表达于腺上皮的胞浆和胞膜。瘤旁非肿瘤黏膜和LGD组织的DOK3高表达率均显著高于HGD和结肠癌组织(P<0.05);HGD组织的DOK3高表达率也显著高于结肠癌组织(P<0.05)。结肠癌和HGD组织的PTK7高表达率均显著高于瘤旁非肿瘤黏膜和LGD组织(P<0.05);结肠癌组织的PTK7高表达率也显著高于HGD组织(P<0.05)。结论DOK3可能是作为抑癌因子,而PTK7作为促癌因子参与结肠癌的发生、发展。 展开更多
关键词 结肠腺瘤伴低级别异型增生 结肠腺瘤伴高级别异型增生 结肠癌 瘤旁非肿瘤黏膜组织 对接蛋白3 蛋白酪氨酸激酶7
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HPV E6/E7联合液基细胞学检查在宫颈癌前病变筛查中的意义 被引量:27
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作者 夏作利 陈国荣 +2 位作者 潘丹 林萍 金茹 《实用医学杂志》 CAS 北大核心 2016年第18期3053-3056,共4页
目的:探讨宫颈E6/E7检测及液基细胞学检查两种方法联合检测在宫颈癌筛查中的意义。方法:筛选温州市人民医院2014年6月至2015年9月间同时行液基细胞学、E6/E7及组织学检查的病例377例,以组织学检查作为金标准。结果 :联合检测可以提高检... 目的:探讨宫颈E6/E7检测及液基细胞学检查两种方法联合检测在宫颈癌筛查中的意义。方法:筛选温州市人民医院2014年6月至2015年9月间同时行液基细胞学、E6/E7及组织学检查的病例377例,以组织学检查作为金标准。结果 :联合检测可以提高检查的敏感性,对低级别鳞状上皮内病变的敏感性为94.41%;对高级别鳞状上皮内病变的敏感性为96.36%。E6/E7检查对高级别鳞状上皮内病变诊断的敏感性为90%,特异性为60.67%,PPV和NPV分别为48.53%、92.49%。液基细胞学对高级别鳞状上皮内病变诊断的敏感性为72.73%,特异性为75.28%,PPV和NPV分别为54.79%、87.01%。结论:E6/E7检查的敏感性比液基细胞学高,而液基细胞学检测特异性较高。E6/E7检测NPV的意义大于液基细胞学。E6/E7及液基细胞学两种方法联合检测可以提高宫颈癌前病变筛查的敏感性,而特异性相似。 展开更多
关键词 宫颈癌前病变 HPV E6/E7 MRNA检测 低级别鳞状上皮内病变 高级别鳞状上皮内病变 液基细胞学
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