Diagnostic accuracy of magnetically guided capsule endoscopy with a detachable string for detecting oesophagogastric varices in adults with cirrhosis: prospective multicentre study

被引：7

作者：

Jiang, Xi ^{[1
]}

Pan, Jun ^{[1
]}

Xu, Qing ^{[2
]}

Song, Yu-Hu ^{[3
]}

Sun, Huan-Huan ^{[4
]}

Peng, Cheng ^{[5
]}

Qi, Xiao-Long ^{[6
,12
]}

Qian, Yang -Yang ^{[1
]}

Zou, Wen-Bin ^{[1
]}

Yang, Yang ^{[7
]}

Jin, Shao-Qin ^{[8
]}

Duan, Ben-Song ^{[9
]}

Wu, Shan ^{[10
]}

Chu, Ye ^{[11
]}

Xiao, Ding-Hua ^{[12
]}

Hu, Li -Juan ^{[13
]}

Cao, Jun-Zhi ^{[14
]}

Dai, Jin-Feng ^{[15
]}

Liu, Xiao ^{[1
]}

Xia, Tian ^{[1
]}

Zhou, Wei ^{[1
]}

Chen, Tao ^{[9
]}

Zhou, Chun-Hua ^{[11
]}

Wu, Wei ^{[11
]}

Liu, Shao-Jun ^{[12
]}

Yang, Zhen-Yu ^{[12
]}

Wang, Fen ^{[12
]}

Zhang, Lu ^{[15
]}

Li, Cheng-Zhong ^{[16
]}

Xu, Hao ^{[16
]}

Wang, Jun-Xue ^{[17
]}

Wei, Bo ^{[17
]}

Lin, Yong ^{[18
]}

Deng, Xing ^{[18
]}

Qu, Li -Hong ^{[15
,19
]}

Shen, Ying-Qiu ^{[19
]}

Wang, Hui ^{[20
]}

Huang, Yi-Fei ^{[21
]}

Bao, Hai-Biao ^{[15
]}

Zhang, Shuo ^{[22
]}

Li, Li ^{[14
]}

Shi, Yi-Hai ^{[13
]}

Wang, Xiao-Yan

Zou, Duo -Wu ^{[11
]}

Wan, Xin-Jian ^{[10
]}

Xu, Mei-Dong ^{[9
]}

Mao, Hua ^{[8
]}

He, Chao -Hui ^{[7
]}

Li, Zhen ^{[5
]}

Zuo, Xiu-Li ^{[5
]}

机构：

[1] Naval Med Univ, Natl Key Lab Immun & Inflammat, Natl Clin Res Ctr Digest Dis, Dept Gastroenterol,Changhai Clin Res Unit,Changhai, Shanghai 200433, Peoples R China

[2] Tongji Univ, Tongji Hosp, Sch Med, Dept Gastroenterol & Hepatol, Shanghai, Peoples R China

[3] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Gastroenterol, Wuhan, Peoples R China

[4] Xi An Jiao Tong Univ, Dept Rheumatism & Immunol, Dept Renal Transplantat, Ctr Nephrol,Affiliated Hosp 1, Xian, Peoples R China

[5] Shandong Univ, Qilu Hosp, Cheeloo Coll Med, Dept Gastroenterol, Jinan, Peoples R China

[6] Southeast Univ, Zhongda Hosp, Nurturing Ctr Jiangsu Prov State Lab AI Imaging &, Basic Med Res & Innovat Ctr,Minist Educ,CHESS Ctr, Nanjing, Peoples R China

[7] Zunyi Med Univ, Affiliated Zhuhai Hosp 5, Dept Gastroenterol & Endoscopy, Zhuhai, Peoples R China

[8] Southern Med Univ, Zhujiang Hosp, Dept Gastroenterol, Guangzhou, Peoples R China

[9] Tongji Univ, Sch Med, Shanghai East Hosp, Endoscopy Ctr,Dept Gastroenterol, Shanghai, Peoples R China

[10] Shanghai Jiao Tong Univ Affiliated Peoples Hosp 6, Dept Endoscopy, Shanghai, Peoples R China

[11] Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Gastroenterol, Shanghai, Peoples R China

[12] Cent South Univ, Xiangya Hosp 3, Dept Gastroenterol, Changsha, Peoples R China

[13] Shanghai Pudong New Area Gongli Hosp, Dept Gastroenterol, Shanghai, Peoples R China

[14] Tongji Univ, Yangpu Hosp, Dept Orthopaed, Shanghai, Peoples R China

[15] Zhejiang Chinese Med Univ, Dept Gastroenterol, Affiliated Hosp 1, Hangzhou, Peoples R China

[16] Naval Med Univ, Changhai Hosp, Dept Infect Dis, Shanghai, Peoples R China

[17] Naval Med Univ, Changzheng Hosp, Dept Infect, Shanghai, Peoples R China

[18] Naval Med Univ, Changzheng Hosp, Dept Gastroenterol, Shanghai, Peoples R China

[19] Tongji Univ, Dept Infect Dis, Shanghai East Hosp, Sch Med, Shanghai, Peoples R China

[20] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Infect Dis, Sch Med, Shanghai, Peoples R China

[21] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Gastroenterol, Guangzhou, Peoples R China

[22] Zhejiang Chinese Med Univ, Dept Rheumatol, Affiliated Hosp 2, Hangzhou, Zhejiang, Peoples R China

[23] Fdn Policlin Univ Agostino Gemelli IRCCS, Digest Endoscopy Unit, Rome, Italy

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2024年 / 384卷

关键词：

PORTAL HYPERTENSIVE ENTEROPATHY; ESOPHAGEAL-VARICES; CONSENSUS WORKSHOP; SMALL-BOWEL; RISK; ESOPHAGOGASTRODUODENOSCOPY; SURVEILLANCE; GASTROSCOPY; METHODOLOGY;

D O I：

10.1136/bmj-2023-078581

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE To evaluate the diagnostic accuracy and safety of using magnetically guided capsule endoscopy with a detachable string (ds-MCE) for detecting and grading oesophagogastric varices in adults with cirrhosis. DESIGN Prospective multicentre diagnostic accuracy study. SETTING 14 medical centres in China. PARTICIPANTS 607 adults (>18 years) with cirrhosis recruited between 7 January 2021 and 25 August 2022. Participants underwent ds-MCE (index test), followed by oesophagogastroduodenoscopy (OGD, reference test) within 48 hours. The participants were divided into development and validation cohorts in a ratio of 2:1. MAIN OUTCOME MEASURES The primary outcomes were the sensitivity and specificity of ds-MCE in detecting oesophagogastric varices compared with OGD. Secondary outcomes included the sensitivity and specificity of ds-MCE for detecting high risk oesophageal varices and the diagnostic accuracy of ds-MCE for detecting high risk oesophagogastric varices, oesophageal varices, and gastric varices. RESULTS ds-MCE and OGD examinations were completed in 582 (95.9%) of the 607 participants. Using OGD as the reference standard, ds-MCE had a sensitivity of 97.5% (95% confidence interval 95.5% to 98.7%) and specificity of 97.8% (94.4% to 99.1%) for detecting oesophagogastric varices (both P<0.001 compared with a prespecified 85% threshold). When using the optimal 18% threshold for luminal circumference of the oesophagus derived from the development cohort (n=393), the sensitivity and specificity of ds-MCE for detecting high risk oesophageal varices in the validation cohort (n=189) were 95.8% (89.7% to 98.4%) and 94.7% (88.2% to 97.7%), respectively. The diagnostic accuracy of ds-MCE for detecting high risk oesophagogastric varices, oesophageal varices, and gastric varices was 96.3% (92.6% to 98.2%), 96.9% (95.2% to 98.0%), and 96.7% (95.0% to 97.9%), respectively. Two serious adverse events occurred with OGD but none with ds-MCE. CONCLUSION The findings of this study suggest that ds-MCE is a highly accurate and safe diagnostic tool for detecting and grading oesophagogastric varices and is a promising alternative to OGD for screening and surveillance of oesophagogastric varices in patients with cirrhosis.

引用

页数：11

共 20 条

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