Use of pronase in screening for early cancers of the upper gastrointestinal tract.

Abstract

Introduction: This study aimed to investigate the effectiveness of pronase in improving the detection rate of early cancer and enhancing visual field clarity during gastroscopy in China.

Methods: In total, 1450 patients who participated in an early diagnosis and treatment programme of upper gastrointestinal cancer in Wuwei, Gansu Province between 2020 and 2021 were enrolled. Cluster randomisation was utilised at the community level. All patients underwent endoscopy and biopsy. The experimental group (n=725) received pronase granules and dimethicone prior to gastroscopy; the control group (n=725) received dimethicone alone. Endoscopic visibility scores, examination durations, and lesion detection rates were recorded for both groups.

Results: Visibility scores for all regions of the stomach were significantly lower in the experimental group than in the control group (P<0.001). This finding remained consistent after adjustment for confounding factors in multiple linear regression analysis. The detection rate of precancerous lesions and early cancer was significantly higher in the experimental group than in the control group (77.5% vs 62.5%; P<0.001). Binary logistic regression analysis indicated that the likelihood of detecting early cancer was greater in the experimental group, with an odds ratio of 3.840 (95% confidence interval=1.204-12.241; P=0.023). Also, average gastroscopy time was significantly shorter in the experimental group than in the control group (6.52±2.51 min vs 10.03±1.23 min, t=33.81; P=0.001).

Conclusion: The administration of pronase prior to gastroscopy enhances visual field clarity, reduces examination time, and increases the detection rates of precancerous lesions and early cancer.