Are alarm symptoms valuable in predicting upper gastrointestinal malignancy?

Öz

Background and Aims: The diagnostic utility of alarm symptoms in predicting upper gastrointestinal cancers is uncertain. In our study, we aimed to investigate the predictive value of alarm symptoms in the diagnosis of upper gastrointestinal cancers. Materials and Methods: This prospective observational study included patients with at least one or more alarm symptoms of upper gastrointestinal cancers who underwent esophagogastroduodenoscopy. Patients under 18 years of age and over 80 years of age were excluded. Patients were divided into two groups as under and over 45 years of age. Demographic characteristics, presenting complaints, alarm symptoms, endoscopy and pathology results were evaluated prospectively. Results: A total of 325 patients were included in the study, 62.5% of whom were female, with a mean age of 50.8 ± 15.8 years. The most common alarm symptoms were new-onset dyspepsia over 45 years of age (48.6%), weight loss (34.8%) and iron deficiency anemia (31.1%), respectively. In our study, malignancy was diagnosed in 8 patients (2.5%), 6 of whom were male, and all of whom were over 45 years of age. The alarm symptoms with the highest sensitivity were weight loss (75%) and iron deficiency anemia (50%), while the alarm symptoms with the highest specificity were palpable abdominal/epigastric mass or abnormal lymphadenopathy (96.5%) and upper gastrointestinal bleeding (96.2%). Conclusion: The sensitivity and specificity of alarming features in predicting upper gastrointestinal cancers is limited and other methods need to be developed to define the at-risk population.

Anahtar Kelimeler

• Alarm features
• alarm symptoms
• dyspepsia
• malignancy
• upper gastrointestinal malignancy

Alarm semptomları üst gastrointestinal maligniteyi öngörmede değerli midir?

Öz

Giriş ve Amaç: Alarm semptomlarının üst gastrointestinal kanserlerini öngörmedeki tanısal faydası belirsizdir. Çalışmamızda, alarm semptomlarının üst gastrointestinal kanserlerinin tanısında öngörücü değerini araştırmayı amaçladık. Gereç ve Yöntem: Bu prospektif gözlemsel çalışmaya, üst gastrointestinal sistem kanserlerine yönelik en az bir veya daha fazla alarm semptomu olan ve özofagogastroduodenoskopi yapılan hastalar dahil edildi. On sekiz yaş altı ve 80 yaş üstü hastalar çalışma dışı bırakıldı. Hastalar 45 yaş altı ve üstü olarak iki gruba ayrıldı. Hastaların demografik özellikleri, başvuru şikayetleri, alarm semptomları, endoskopi ve patoloji sonuçları prospektif olarak değerlendirildi. Bulgular: Çalışmaya %62,5’i kadın, yaş ortalamaları 50,8 ± 15,8 yıl olan toplam 325 hasta dahil edildi. En sık görülen alarm semptomları sırasıyla 45 yaş üzeri başlayan dispepsi (%48,6), kilo kaybı (%34,8) ve demir eksikliği anemisi (%31,1) idi. Çalışmamızda tamamı 45 yaş üstünde olan 6’sı erkek toplam 8 hastaya (%2,5) malignite tanısı konuldu. Malignite tanısında sensitivitesi en yüksek alarm semptomları kilo kaybı (%75) ve demir eksikliği anemisi (%50), spesifitesi en yüksek alarm semptomları ise palpable abdominal/epigastrik kitle veya anormal lenfadenopati (%96,5) ve üst gastrotintestinal sistem kanaması (%96,2) idi. Sonuç: Üst gastrointestinal kanserleri öngörmede alarm bulgularının duyarlılığı ve özgüllüğü sınırlıdır ve risk altındaki popülasyonu tanımlamak için başka yöntemlerin geliştirilmesine ihtiyaç vardır.

Anahtar Kelimeler

• Alarm özellikleri
• alarm semptomları
• dispepsi
• malignite
• üst gastrointestinal malignite

Kaynakça

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