Alarm features and age for predicting upper gastrointestinal malignancy in Chinese patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper gastrointestinal malignancy: an endoscopic database review of 102 665 patients from 1996 to 2006
ObjectivePatients with dyspepsia with alarm features are suspected of having upper gastrointestinal (GI) malignancy; however, the true value of alarm features in predicting an underlying malignancy for patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper...
Gespeichert in:
| Veröffentlicht in: | Gut 2010-06, Vol.59 (6), p.722-728 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 728 |
|---|---|
| container_issue | 6 |
| container_start_page | 722 |
| container_title | Gut |
| container_volume | 59 |
| creator | Bai, Yu Li, Zhao-Shen Zou, Duo-Wu Wu, Ren-Pei Yao, Yin-Zhen Jin, Zhen-Dong Ye, Ping Li, Shu-De Zhang, Wen-Jun Du, Yi-Qi Zhan, Xian-Bao Liu, Feng Gao, Jun Xu, Guo-Ming |
| description | ObjectivePatients with dyspepsia with alarm features are suspected of having upper gastrointestinal (GI) malignancy; however, the true value of alarm features in predicting an underlying malignancy for patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper GI malignancy is uncertain. The aim of the present study was to determine the diagnostic accuracy of alarm features in predicting upper GI malignancy by reviewing an endoscopic database consisting of >100 000 Chinese patients.MethodsA retrospective analysis of prospectively collected data was conducted in a single tertiary medical centre. Consecutive patients who underwent oesophagogastroduodenoscopy (OGD) for dyspepsia in 1996–2006 were enrolled. The data including gender, age, symptoms, and endoscopic and pathological findings were analysed. The main outcome measure was the diagnostic accuracy of individual alarm feature.Results102 665 patients were included in the final analysis. Among all the 4362 patients with malignancy, 52% (2258/4362) had alarm features. Among 15 235 patients who had alarm features, 2258 (14.8%) were found to have upper GI malignancy. The pooled sensitivity and specificity of the alarm features were 13.4% and 96.6%, respectively. Only the feature of dysphagia in patients between 36 and 74 years old had a positive likelihood ratio (PLR) >10 for malignancy prediction, while all other alarm features in other age groups had a PLR |
| doi_str_mv | 10.1136/gut.2009.192401 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733346639</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733346639</sourcerecordid><originalsourceid>FETCH-LOGICAL-b427t-9b8de8c3d0c63a3ab60d2a19d6b7d38160fff8f7b2cdbf5eb2a90a057309d34e3</originalsourceid><addsrcrecordid>eNqFkk9v1DAQxQMC0aVwhhOyhBAS0rZ2nNgxt7ICiiggIUDcrIn_ZN0mcbAdyt648jX5JHjZ0kpcerLs-Xnem9ErigcEHxBC2WE3p4MSY3FARFlhcrNYkIo1S1o2za1igTHhy5pXYq-4G-MpxrhpBLlT7JW4rklV14sbD496CAOyBtIcTEQwagSdQdYHNAWjnUpu7NA8TSagDmIK3o3JxPwKPRqgd90Io9ogN6LV2o0mGjRBcmZMEZ27tEZ6EyczRQe769p1a9SCOuuCn7NYFvkOvRmVQd6iY9M75XM5Zblp0_vgcmdrsgs__jV3rZPnGUNm1D4qPzmFNCRoIdvKQs6cb1UILn___MVYfWXVBj8gIgRDyaO8UXavuG2hj-b-xblffH718tPqeHny4fWb1dHJsq1KnpaibbRpFNVYMQoUWoZ1CURo1nJNG8KwtbaxvC2Vbm1t2hIEBlxzioWmlaH7xdNd3yn4b3MeRw4uKtP3MBo_R8kppRVjVGTy8X_kqZ9DHj5KwrmgvKSiztThjlLBxxiMlVNwA4SNJFhuMyNzZuQ2M3KXmfzj0UXfuR2MvuT_hSQDTy4AiAp6G_KaXbziSt6IGuPMLXeci8n8uKxDOJOMU17L919W8t1X_GKF336U24Ge7fh2OL3W5R-oJezA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1779372395</pqid></control><display><type>article</type><title>Alarm features and age for predicting upper gastrointestinal malignancy in Chinese patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper gastrointestinal malignancy: an endoscopic database review of 102 665 patients from 1996 to 2006</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Bai, Yu ; Li, Zhao-Shen ; Zou, Duo-Wu ; Wu, Ren-Pei ; Yao, Yin-Zhen ; Jin, Zhen-Dong ; Ye, Ping ; Li, Shu-De ; Zhang, Wen-Jun ; Du, Yi-Qi ; Zhan, Xian-Bao ; Liu, Feng ; Gao, Jun ; Xu, Guo-Ming</creator><creatorcontrib>Bai, Yu ; Li, Zhao-Shen ; Zou, Duo-Wu ; Wu, Ren-Pei ; Yao, Yin-Zhen ; Jin, Zhen-Dong ; Ye, Ping ; Li, Shu-De ; Zhang, Wen-Jun ; Du, Yi-Qi ; Zhan, Xian-Bao ; Liu, Feng ; Gao, Jun ; Xu, Guo-Ming</creatorcontrib><description>ObjectivePatients with dyspepsia with alarm features are suspected of having upper gastrointestinal (GI) malignancy; however, the true value of alarm features in predicting an underlying malignancy for patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper GI malignancy is uncertain. The aim of the present study was to determine the diagnostic accuracy of alarm features in predicting upper GI malignancy by reviewing an endoscopic database consisting of >100 000 Chinese patients.MethodsA retrospective analysis of prospectively collected data was conducted in a single tertiary medical centre. Consecutive patients who underwent oesophagogastroduodenoscopy (OGD) for dyspepsia in 1996–2006 were enrolled. The data including gender, age, symptoms, and endoscopic and pathological findings were analysed. The main outcome measure was the diagnostic accuracy of individual alarm feature.Results102 665 patients were included in the final analysis. Among all the 4362 patients with malignancy, 52% (2258/4362) had alarm features. Among 15 235 patients who had alarm features, 2258 (14.8%) were found to have upper GI malignancy. The pooled sensitivity and specificity of the alarm features were 13.4% and 96.6%, respectively. Only the feature of dysphagia in patients between 36 and 74 years old had a positive likelihood ratio (PLR) >10 for malignancy prediction, while all other alarm features in other age groups had a PLR <10.ConclusionsFor uninvestigated Chinese patients with dyspepsia with high background prevalence of H pylori infection and upper GI malignancy, alarm features and age, except for dysphagia in patients between 36 and 74 years old, had limited predictive value for a potential malignancy; therefore, prompt endoscopy may be recommended for these patients. However, less invasive, inexpensive screening methods with high diagnostic yield are still needed to reduce unnecessary endoscopy workload.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gut.2009.192401</identifier><identifier>PMID: 20551455</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Abdomen ; Adult ; Age ; Age Factors ; Aged ; Alarm features ; Antidepressants ; Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Biological and medical sciences ; Biopsy ; China - epidemiology ; dyspepsia ; Dyspepsia - epidemiology ; Dyspepsia - etiology ; Dysphagia ; Endoscopy ; Endoscopy, Gastrointestinal ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Neoplasms - complications ; Gastrointestinal Neoplasms - diagnosis ; Gastrointestinal Neoplasms - epidemiology ; gastrointestinal tract ; Helicobacter Infections - complications ; Helicobacter Infections - epidemiology ; Helicobacter pylori ; Hemorrhage ; Hospitals ; Human bacterial diseases ; Humans ; Infections ; Infectious diseases ; Male ; Medical sciences ; Methods ; Middle Aged ; Other diseases. Semiology ; Primary care ; Retrospective Studies ; Sensitivity and Specificity ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Studies ; Tumors ; Ulcers ; upper gastrointestinal endoscopy ; upper gastrointestinal malignancy</subject><ispartof>Gut, 2010-06, Vol.59 (6), p.722-728</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b427t-9b8de8c3d0c63a3ab60d2a19d6b7d38160fff8f7b2cdbf5eb2a90a057309d34e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://gut.bmj.com/content/59/6/722.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://gut.bmj.com/content/59/6/722.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22789500$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20551455$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bai, Yu</creatorcontrib><creatorcontrib>Li, Zhao-Shen</creatorcontrib><creatorcontrib>Zou, Duo-Wu</creatorcontrib><creatorcontrib>Wu, Ren-Pei</creatorcontrib><creatorcontrib>Yao, Yin-Zhen</creatorcontrib><creatorcontrib>Jin, Zhen-Dong</creatorcontrib><creatorcontrib>Ye, Ping</creatorcontrib><creatorcontrib>Li, Shu-De</creatorcontrib><creatorcontrib>Zhang, Wen-Jun</creatorcontrib><creatorcontrib>Du, Yi-Qi</creatorcontrib><creatorcontrib>Zhan, Xian-Bao</creatorcontrib><creatorcontrib>Liu, Feng</creatorcontrib><creatorcontrib>Gao, Jun</creatorcontrib><creatorcontrib>Xu, Guo-Ming</creatorcontrib><title>Alarm features and age for predicting upper gastrointestinal malignancy in Chinese patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper gastrointestinal malignancy: an endoscopic database review of 102 665 patients from 1996 to 2006</title><title>Gut</title><addtitle>Gut</addtitle><description>ObjectivePatients with dyspepsia with alarm features are suspected of having upper gastrointestinal (GI) malignancy; however, the true value of alarm features in predicting an underlying malignancy for patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper GI malignancy is uncertain. The aim of the present study was to determine the diagnostic accuracy of alarm features in predicting upper GI malignancy by reviewing an endoscopic database consisting of >100 000 Chinese patients.MethodsA retrospective analysis of prospectively collected data was conducted in a single tertiary medical centre. Consecutive patients who underwent oesophagogastroduodenoscopy (OGD) for dyspepsia in 1996–2006 were enrolled. The data including gender, age, symptoms, and endoscopic and pathological findings were analysed. The main outcome measure was the diagnostic accuracy of individual alarm feature.Results102 665 patients were included in the final analysis. Among all the 4362 patients with malignancy, 52% (2258/4362) had alarm features. Among 15 235 patients who had alarm features, 2258 (14.8%) were found to have upper GI malignancy. The pooled sensitivity and specificity of the alarm features were 13.4% and 96.6%, respectively. Only the feature of dysphagia in patients between 36 and 74 years old had a positive likelihood ratio (PLR) >10 for malignancy prediction, while all other alarm features in other age groups had a PLR <10.ConclusionsFor uninvestigated Chinese patients with dyspepsia with high background prevalence of H pylori infection and upper GI malignancy, alarm features and age, except for dysphagia in patients between 36 and 74 years old, had limited predictive value for a potential malignancy; therefore, prompt endoscopy may be recommended for these patients. However, less invasive, inexpensive screening methods with high diagnostic yield are still needed to reduce unnecessary endoscopy workload.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Alarm features</subject><subject>Antidepressants</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>China - epidemiology</subject><subject>dyspepsia</subject><subject>Dyspepsia - epidemiology</subject><subject>Dyspepsia - etiology</subject><subject>Dysphagia</subject><subject>Endoscopy</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal Neoplasms - complications</subject><subject>Gastrointestinal Neoplasms - diagnosis</subject><subject>Gastrointestinal Neoplasms - epidemiology</subject><subject>gastrointestinal tract</subject><subject>Helicobacter Infections - complications</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter pylori</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Primary care</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Studies</subject><subject>Tumors</subject><subject>Ulcers</subject><subject>upper gastrointestinal endoscopy</subject><subject>upper gastrointestinal malignancy</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkk9v1DAQxQMC0aVwhhOyhBAS0rZ2nNgxt7ICiiggIUDcrIn_ZN0mcbAdyt648jX5JHjZ0kpcerLs-Xnem9ErigcEHxBC2WE3p4MSY3FARFlhcrNYkIo1S1o2za1igTHhy5pXYq-4G-MpxrhpBLlT7JW4rklV14sbD496CAOyBtIcTEQwagSdQdYHNAWjnUpu7NA8TSagDmIK3o3JxPwKPRqgd90Io9ogN6LV2o0mGjRBcmZMEZ27tEZ6EyczRQe769p1a9SCOuuCn7NYFvkOvRmVQd6iY9M75XM5Zblp0_vgcmdrsgs__jV3rZPnGUNm1D4qPzmFNCRoIdvKQs6cb1UILn___MVYfWXVBj8gIgRDyaO8UXavuG2hj-b-xblffH718tPqeHny4fWb1dHJsq1KnpaibbRpFNVYMQoUWoZ1CURo1nJNG8KwtbaxvC2Vbm1t2hIEBlxzioWmlaH7xdNd3yn4b3MeRw4uKtP3MBo_R8kppRVjVGTy8X_kqZ9DHj5KwrmgvKSiztThjlLBxxiMlVNwA4SNJFhuMyNzZuQ2M3KXmfzj0UXfuR2MvuT_hSQDTy4AiAp6G_KaXbziSt6IGuPMLXeci8n8uKxDOJOMU17L919W8t1X_GKF336U24Ge7fh2OL3W5R-oJezA</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Bai, Yu</creator><creator>Li, Zhao-Shen</creator><creator>Zou, Duo-Wu</creator><creator>Wu, Ren-Pei</creator><creator>Yao, Yin-Zhen</creator><creator>Jin, Zhen-Dong</creator><creator>Ye, Ping</creator><creator>Li, Shu-De</creator><creator>Zhang, Wen-Jun</creator><creator>Du, Yi-Qi</creator><creator>Zhan, Xian-Bao</creator><creator>Liu, Feng</creator><creator>Gao, Jun</creator><creator>Xu, Guo-Ming</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Alarm features and age for predicting upper gastrointestinal malignancy in Chinese patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper gastrointestinal malignancy: an endoscopic database review of 102 665 patients from 1996 to 2006</title><author>Bai, Yu ; Li, Zhao-Shen ; Zou, Duo-Wu ; Wu, Ren-Pei ; Yao, Yin-Zhen ; Jin, Zhen-Dong ; Ye, Ping ; Li, Shu-De ; Zhang, Wen-Jun ; Du, Yi-Qi ; Zhan, Xian-Bao ; Liu, Feng ; Gao, Jun ; Xu, Guo-Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b427t-9b8de8c3d0c63a3ab60d2a19d6b7d38160fff8f7b2cdbf5eb2a90a057309d34e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Alarm features</topic><topic>Antidepressants</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the digestive system and abdomen</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>China - epidemiology</topic><topic>dyspepsia</topic><topic>Dyspepsia - epidemiology</topic><topic>Dyspepsia - etiology</topic><topic>Dysphagia</topic><topic>Endoscopy</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal Neoplasms - complications</topic><topic>Gastrointestinal Neoplasms - diagnosis</topic><topic>Gastrointestinal Neoplasms - epidemiology</topic><topic>gastrointestinal tract</topic><topic>Helicobacter Infections - complications</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter pylori</topic><topic>Hemorrhage</topic><topic>Hospitals</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Primary care</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Studies</topic><topic>Tumors</topic><topic>Ulcers</topic><topic>upper gastrointestinal endoscopy</topic><topic>upper gastrointestinal malignancy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bai, Yu</creatorcontrib><creatorcontrib>Li, Zhao-Shen</creatorcontrib><creatorcontrib>Zou, Duo-Wu</creatorcontrib><creatorcontrib>Wu, Ren-Pei</creatorcontrib><creatorcontrib>Yao, Yin-Zhen</creatorcontrib><creatorcontrib>Jin, Zhen-Dong</creatorcontrib><creatorcontrib>Ye, Ping</creatorcontrib><creatorcontrib>Li, Shu-De</creatorcontrib><creatorcontrib>Zhang, Wen-Jun</creatorcontrib><creatorcontrib>Du, Yi-Qi</creatorcontrib><creatorcontrib>Zhan, Xian-Bao</creatorcontrib><creatorcontrib>Liu, Feng</creatorcontrib><creatorcontrib>Gao, Jun</creatorcontrib><creatorcontrib>Xu, Guo-Ming</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bai, Yu</au><au>Li, Zhao-Shen</au><au>Zou, Duo-Wu</au><au>Wu, Ren-Pei</au><au>Yao, Yin-Zhen</au><au>Jin, Zhen-Dong</au><au>Ye, Ping</au><au>Li, Shu-De</au><au>Zhang, Wen-Jun</au><au>Du, Yi-Qi</au><au>Zhan, Xian-Bao</au><au>Liu, Feng</au><au>Gao, Jun</au><au>Xu, Guo-Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alarm features and age for predicting upper gastrointestinal malignancy in Chinese patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper gastrointestinal malignancy: an endoscopic database review of 102 665 patients from 1996 to 2006</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>59</volume><issue>6</issue><spage>722</spage><epage>728</epage><pages>722-728</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><coden>GUTTAK</coden><abstract>ObjectivePatients with dyspepsia with alarm features are suspected of having upper gastrointestinal (GI) malignancy; however, the true value of alarm features in predicting an underlying malignancy for patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper GI malignancy is uncertain. The aim of the present study was to determine the diagnostic accuracy of alarm features in predicting upper GI malignancy by reviewing an endoscopic database consisting of >100 000 Chinese patients.MethodsA retrospective analysis of prospectively collected data was conducted in a single tertiary medical centre. Consecutive patients who underwent oesophagogastroduodenoscopy (OGD) for dyspepsia in 1996–2006 were enrolled. The data including gender, age, symptoms, and endoscopic and pathological findings were analysed. The main outcome measure was the diagnostic accuracy of individual alarm feature.Results102 665 patients were included in the final analysis. Among all the 4362 patients with malignancy, 52% (2258/4362) had alarm features. Among 15 235 patients who had alarm features, 2258 (14.8%) were found to have upper GI malignancy. The pooled sensitivity and specificity of the alarm features were 13.4% and 96.6%, respectively. Only the feature of dysphagia in patients between 36 and 74 years old had a positive likelihood ratio (PLR) >10 for malignancy prediction, while all other alarm features in other age groups had a PLR <10.ConclusionsFor uninvestigated Chinese patients with dyspepsia with high background prevalence of H pylori infection and upper GI malignancy, alarm features and age, except for dysphagia in patients between 36 and 74 years old, had limited predictive value for a potential malignancy; therefore, prompt endoscopy may be recommended for these patients. However, less invasive, inexpensive screening methods with high diagnostic yield are still needed to reduce unnecessary endoscopy workload.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>20551455</pmid><doi>10.1136/gut.2009.192401</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0017-5749 |
| ispartof | Gut, 2010-06, Vol.59 (6), p.722-728 |
| issn | 0017-5749 1468-3288 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_733346639 |
| source | MEDLINE; BMJ Journals - NESLi2; PubMed Central |
| subjects | Abdomen Adult Age Age Factors Aged Alarm features Antidepressants Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Biopsy China - epidemiology dyspepsia Dyspepsia - epidemiology Dyspepsia - etiology Dysphagia Endoscopy Endoscopy, Gastrointestinal Female Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Neoplasms - complications Gastrointestinal Neoplasms - diagnosis Gastrointestinal Neoplasms - epidemiology gastrointestinal tract Helicobacter Infections - complications Helicobacter Infections - epidemiology Helicobacter pylori Hemorrhage Hospitals Human bacterial diseases Humans Infections Infectious diseases Male Medical sciences Methods Middle Aged Other diseases. Semiology Primary care Retrospective Studies Sensitivity and Specificity Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Studies Tumors Ulcers upper gastrointestinal endoscopy upper gastrointestinal malignancy |
| title | Alarm features and age for predicting upper gastrointestinal malignancy in Chinese patients with dyspepsia with high background prevalence of Helicobacter pylori infection and upper gastrointestinal malignancy: an endoscopic database review of 102 665 patients from 1996 to 2006 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T04%3A04%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Alarm%20features%20and%20age%20for%20predicting%20upper%20gastrointestinal%20malignancy%20in%20Chinese%20patients%20with%20dyspepsia%20with%20high%20background%20prevalence%20of%20Helicobacter%20pylori%20infection%20and%20upper%20gastrointestinal%20malignancy:%20an%20endoscopic%20database%20review%20of%20102%E2%80%89665%20patients%20from%201996%20to%202006&rft.jtitle=Gut&rft.au=Bai,%20Yu&rft.date=2010-06-01&rft.volume=59&rft.issue=6&rft.spage=722&rft.epage=728&rft.pages=722-728&rft.issn=0017-5749&rft.eissn=1468-3288&rft.coden=GUTTAK&rft_id=info:doi/10.1136/gut.2009.192401&rft_dat=%3Cproquest_cross%3E733346639%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1779372395&rft_id=info:pmid/20551455&rfr_iscdi=true |