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Diagnostic accuracy of magnetically guided capsule endoscopy with a detachable string for detecting oesophagogastric varices in adults with cirrhosis: prospective multicentre study.
Jiang, Xi; Pan, Jun; Xu, Qing; Song, Yu-Hu; Sun, Huan-Huan; Peng, Cheng; Qi, Xiao-Long; Qian, Yang-Yang; Zou, Wen-Bin; Yang, Yang; Jin, Shao-Qin; Duan, Ben-Song; Wu, Shan; Chu, Ye; Xiao, Ding-Hua; Hu, Li-Juan; Cao, Jun-Zhi; Dai, Jin-Feng; Liu, Xiao; Xia, Tian; Zhou, Wei; Chen, Tao; Zhou, Chun-Hua; Wu, Wei; Liu, Shao-Jun; Yang, Zhen-Yu; Wang, Fen; Zhang, Lu; Li, Cheng-Zhong; Xu, Hao; Wang, Jun-Xue; Wei, Bo; Lin, Yong; Deng, Xing; Qu, Li-Hong; Shen, Ying-Qiu; Wang, Hui; Huang, Yi-Fei; Bao, Hai-Biao; Zhang, Shuo; Li, Li; Shi, Yi-Hai; Wang, Xiao-Yan; Zou, Duo-Wu; Wan, Xin-Jian; Xu, Mei-Dong; Mao, Hua; He, Chao-Hui; Li, Zhen; Zuo, Xiu-Li.
Afiliação
  • Jiang X; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Pan J; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Xu Q; Department of Gastroenterology and Hepatology, Tongji Hospital of Tongji University School of Medicine, Shanghai, China.
  • Song YH; Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Sun HH; Department of Gastroenterology, Shanxi Clinical Research Centre of Digestive Disease (cancer division), the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Peng C; Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
  • Qi XL; CHESS Centre, Department of Radiology, Basic Medicine Research and Innovation Centre of Ministry of Education, Zhongda Hospital, Medical School, Southeast University, Nurturing Centre of Jiangsu Province for State Laboratory of AI Imaging and Interventional Radiology, Nanjing, China.
  • Qian YY; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Zou WB; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Yang Y; Department of Gastroenterology and Endoscopy, The Fifth affiliated Zhuhai Hospital of Zunyi Medical University, Zhuhai, China.
  • Jin SQ; Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
  • Duan BS; Department of Gastroenterology, Endoscopy Centre, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
  • Wu S; Department of Endoscopy, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
  • Chu Y; Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Xiao DH; Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
  • Hu LJ; Department of Gastroenterology, Shanghai Pudong New Area Gongli Hospital, Shanghai, China.
  • Cao JZ; Department of Gastroenterology, Yangpu Hospital, Tongji University, Shanghai, China.
  • Dai JF; Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
  • Liu X; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Xia T; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Zhou W; Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Chen T; Department of Gastroenterology, Endoscopy Centre, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
  • Zhou CH; Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Wu W; Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Liu SJ; Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
  • Yang ZY; Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
  • Wang F; Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
  • Zhang L; Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
  • Li CZ; Department of Infectious Diseases, Changhai Hospital, Naval Medical University, Shanghai, China.
  • Xu H; Department of Infectious Diseases, Changhai Hospital, Naval Medical University, Shanghai, China.
  • Wang JX; Department of Infection, Changzheng Hospital, Naval Medical University, Shanghai, China.
  • Wei B; Department of Infection, Changzheng Hospital, Naval Medical University, Shanghai, China.
  • Lin Y; Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China.
  • Deng X; Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China.
  • Qu LH; Department of Infectious Diseases, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
  • Shen YQ; Department of Infectious Diseases, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
  • Wang H; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Huang YF; Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
  • Bao HB; Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
  • Zhang S; Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang Chinese University, Hangzhou, China.
  • Li L; Department of Gastroenterology, Yangpu Hospital, Tongji University, Shanghai, China.
  • Shi YH; Department of Gastroenterology, Shanghai Pudong New Area Gongli Hospital, Shanghai, China.
  • Wang XY; Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
  • Zou DW; Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Wan XJ; Department of Endoscopy, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
  • Xu MD; Department of Gastroenterology, Endoscopy Centre, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
  • Mao H; Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
  • He CH; Department of Gastroenterology and Endoscopy, The Fifth affiliated Zhuhai Hospital of Zunyi Medical University, Zhuhai, China.
  • Li Z; Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
  • Zuo XL; Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
BMJ ; 384: e078581, 2024 03 05.
Article em En | MEDLINE | ID: mdl-38443074
ABSTRACT

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 21. 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. TRIAL REGISTRATION ClinicalTrials.gov NCT03748563.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Varizes / Varizes Esofágicas e Gástricas / Endoscopia por Cápsula Limite: Adult / Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Varizes / Varizes Esofágicas e Gástricas / Endoscopia por Cápsula Limite: Adult / Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article