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Endoscopia
versão On-line ISSN 2444-6483versão impressa ISSN 0188-9893
Resumo
SANTACREO-POSAS, Martha Julia et al. Impacto de la endoscopia sistemática alfanumérica codificada versus la endoscopia convencional en la detección de lesiones gástricas premalignas en el hospital juárez de México. Endoscopia [online]. 2019, vol.31, suppl.2, pp.327-333. Epub 14-Fev-2022. ISSN 2444-6483. https://doi.org/10.24875/end.m19000118.
Gastric cancer is the second most common cause of cancer death worldwide. In Mexico, the detection rate of early gastric cancer is low (10% to 20%), which results in a mainly palliative treatment. The Codified Alphanumeric Systematic Endoscopy (ESAC) approach has been proposed to improve the quality of EGD by facilitating the complete examination of the upper gastrointestinal tract based on simple, sequential and systematic photographic documentation.
Objective:
To determine the impact of encoded alpha numerical systematic endoscopy in the detection of pre malignant gastric lesions.
Material and methods:
Cross-sectional, cohort, prospective, unicentric study. All patients referred to the endoscopy service of the Hospital Juárez de México with diagnosis of dyspepsia in the period April-June 2019 were included and were submitted in order of one to one conventional EGD and systematic alphanumeric EGD coded respectively. The following were analyzed: average age, gender, BMI, comorbidities, habits, socioeconomic status, consumption of PPIs, family history of gastric cancer, time of the procedure, endoscopic visibility, endoscopic diagnosis and histopathological diagnosis, index of lesion detection.
Results:
57 patients with an average age of 54.8 years were included. Men 24.5% (n = 14) and 75.4% (n = 43) women. Average BMI of 27.3. 98.2% of the patients were with low socioeconomic status. Of the total patients, 28 (49%) were subjected to ESCA and 29 (51%) to conventional endoscopy. The average time of each study was 17.14 minutes for the conventional technique and 17.39 minutes for the ESCA technique, (95% CI -2.37-1.86, p 0.81) statistically non-significant. Good visibility was achieved in 98.2% (Bhandari 2 89.5%). The histopathological confirmation of 26 studies is available: 50% 13/26 chronic gastritis associated with H. pylori, 15% 4/26 with a diagnosis of intestinal metaplasia and 3.8% (1/26) high grade dysplasia. With the conventional technique, 37% diagnostic accuracy, negative predictive value (NPV) of 72% and a detection rate of premalignant lesions of 10.52% were obtained. The ESAC technique had a diagnostic accuracy of 28.5% and a NPV of 100%.
Conclusions:
In this study the ESAC proved to be better in terms of NPV, however conventional endoscopy had a diagnostic accuracy and a higher detection rate of premalignant gastric lesions. There is no difference in the duration of endoscopic studies between both techniques.
Palavras-chave : Endoscopy; Early gastric cancer; Preneoplasic lesions.
