Gastroenterology:囊性纤维化患者结肠癌筛查模式的成本效益研究

2017-12-28 zhangfan MedSci原创

研究确定了囊性纤维化患者最具效益的结肠癌筛查模式,鉴于患者结肠癌风险较高,囊性纤维化患者应较早开始筛查并缩短筛查间隔,粪便免疫化学试验是有效的补充筛查方法

与一般人群相比,囊性纤维化患者结直肠癌风险增加,器官移植后囊性纤维化患者的结直肠癌风险更高。近日研究人员对囊性纤维化患者结肠癌筛查的风险效应进行了评估。

研究对已有的结肠微模拟模型进行调整以用于本次研究,根据器官移植进行分层。研究模拟了76个结肠癌筛查模型,考察不同年龄段和筛查时间间隔。每$100000生命年为最优的筛选策略。根据粪便免疫化学试验(FIT)结果、早期移植以及结肠镜并发症发生率评估最佳筛查策略的变化。

40岁起,每5年1次结肠镜是未接受过器官移植的囊性纤维化患者的最佳筛查方案,可减少79%的结肠癌死亡病例。对于接受过器官移植的囊性纤维化患者,最优的筛选患者为30或35岁开始。年FIT筛查是最具成本效益的筛查补充方案,但人群中FIT筛查的准确率尚不得而知。

研究确定了囊性纤维化患者最具效益的结肠癌筛查模式,鉴于患者结肠癌风险较高,囊性纤维化患者应较早开始筛查并缩短筛查间隔,粪便免疫化学试验是有效的补充筛查方法。

原始出处:

Andrea Gini et al. Cost-Effectiveness of Screening Individuals With Cystic Fibrosis for Colorectal Cancer. Gastroenterology. December 27, 2017.

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    2018-09-08 许安
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  5. 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    2017-12-31 wolongzxh
  6. 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createdTime=Sat Dec 30 04:45:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504360, encodeId=675d150436043, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Dec 30 04:45:00 CST 2017, time=2017-12-30, status=1, ipAttribution=)]
    2017-12-31 神功盖世

    学习

    0

  7. 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    2017-12-31 sunfeifeiyang

    学习

    0

  8. 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    2017-12-30 神功盖世

    学习

    0

  9. 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随着近几十年囊性纤维化患者的存活期的提高,其并发症相应的增加。最常见的并发症是囊性纤维化相关性糖尿病。推荐治疗是注射胰岛素,但部分患者服用口服抗糖尿病药物来减轻治疗负担。现研究人员对口服抗糖尿病药物的效果和安全性进行评估。Manfred Ballmann等人在奥地利、法国、德国和意大利的49所中心开展一非盲的、对比性随机试验,。招募10岁以上的新诊断糖尿病的囊性纤维化患者。将患者按1:1随机分组,

Am J Resp Crit Care:SPX-101靶向ENaC治疗囊性纤维化!

这些数据表明SPX-101促进ENaC膜浓度持续减低,导致粘液运输显著改善。

Thorax:口服抗菌药物治疗的囊性纤维化患者肺病加重对临床结局有何影响?

2017年4月,发表在《Thorax》的一项由加拿大科学家进行的研究考察了口服抗菌药物治疗的囊性纤维化(CF)患者肺病加重对临床结局的影响。

JCEM:维生素D对于成人囊性纤维化患者肠道菌群的影响

众多周知肠道菌群紊乱可能会加重囊性纤维化(CF)的严重程度,而维生素D缺乏又是CF患者常见的共发病,可能会影响肠道菌群的组成。近日在JCEM上发表的一篇文章则比较了维生素D充足和不足的CF患者的菌群,并评估了每周高剂量维生素D3的补充方案对于维生素D缺乏(25(OH)D<30ng/ml)的CF患者的肠道和呼吸道微生物的影响。

Eur Respir J:慢性感染铜绿假单胞菌患者囊性纤维化痰细胞的蛋白质组学研究

这些发现扩大了研究人员对CF肺疾病发病机制的认识,并确定痰液细胞蛋白具有潜在的作为疾病状态/预后的指标,以及具有作为治疗处方或治疗目标的分层决定因素的潜力。

Free RadicBiol Med:谷胱甘肽缺乏会加重囊性纤维化疾病引起的支气管损害

CF(囊性纤维化)是一种侵犯多脏器的遗传性疾病。主要表现为外分泌腺的功能紊乱、粘液腺增生、分泌液粘稠、汗液氯化钠含量增高。临床上有肺脏、气道、胰腺、肠道、胆道、输精管、子宫颈等的腺管被粘稠分泌物堵塞所引起一系列症状,而以呼吸系统损害最为突出。