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A comparison of the proportion of early stage cholangiocarcinoma found in an ultrasound-screening program compared to walk-in patients.

超声筛查项目中发现的早期胆管癌与步行患者相比的比例比较。

  • 影响因子:2.92
  • DOI:10.1016/j.hpb.2019.10.010
  • 作者列表:"Khuntikeo N","Koonmee S","Sa-Ngiamwibool P","Chamadol N","Laopaiboon V","Titapun A","Yongvanit P","Loilome W","Namwat N","Andrews RH","Petney TN","Thinkhamrop K","Chaichaya N","Tawarungruang C","Thuanman J","Thinkhamrop B
  • 发表时间:2020-06-01
Abstract

BACKGROUND:Patients with cholangiocarcinoma (CCA) usually have no specific symptoms until an advance stage of the disease and curative treatment is not possible. Patients with early stage, operable disease can be found using ultrasonography (US). A US-screening program was implemented in Thailand where CCA incidence is the highest worldwide. Here we evaluate the effectiveness of the program by comparing the proportion of individuals with early stage CCA in the screening group with that of the walk-in group presenting at hospitals with clinical symptoms. METHODS:All patients had a pathological diagnosis of CCA. The difference in the proportions and the 95% confidence interval (CI) were obtained using binomial regression. RESULTS:Of the 762 histologically proven CCA cases, 161 were from the screening group and 601 from the walk-in group. The proportion of early stage CCA (stages 0 to II) diagnosed was 84.5% in the screening and 21.6% in the walk-in groups. After adjustment age, gender, and liver fluke infection, there was a significantly higher proportion (P < 0.001) and higher chance (P < 0.001) of having early stage CCA in the screening group than in the walk-in group. CONCLUSIONS:US-screening is an effective tool for detecting early stage, operable CCA in high incidence areas.

摘要

背景: 胆管癌 (CCA) 患者通常没有特定的症状,直到疾病的进展阶段,并且不可能进行根治性治疗。使用超声检查 (US) 可以发现早期、可手术疾病的患者。在全球 CCA 发病率最高的泰国实施了美国筛查项目。在这里,我们通过比较筛查组中早期 CCA 个体与在医院出现临床症状的步入式组的比例来评价该方案的有效性。 方法: 所有患者均有病理诊断为 CCA。使用二项式回归获得比例差异和 95% 置信区间 (CI)。 结果: 在 762 例经组织学证实的 CCA 病例中,161 例来自筛查组,601 例来自步入式组。筛查中诊断早期 CCA (0 至 II 期) 的比例为 84.5%,步入式组为 21.6%。调整年龄、性别和肝吸虫感染后,肝吸虫感染率明显高于对照组 (P <0.001),肝吸虫感染率明显高于对照组 (P <0.001)。筛查组比步入式组有早期 CCA。 结论: 美国筛查是检测高发区早期、可手术 CCA 的有效工具。

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