摘要
目的通过分析社区大肠癌筛查阳性患者的肠镜精筛结果,探讨大肠癌筛查的重要性。方法对186例广州增城地区社区大肠癌筛查阳性患者的肠镜检查结果和临床资料进行分析。结果 186例大肠癌筛查阳性的患者中,结直肠息肉检出率为43.4%(90/186),其中包括腺瘤的检出率为39.2%(73/186),结直肠癌的检出率为3.8%(7/186)。肠镜检查有异常病变者占61.3%(114/186),其中进展期息肉占29.0%(33/114),非进展期息肉占50.0%(57/114),非肿瘤性病变占14.9%(17/114),恶性肿瘤占6.1%(7/114);正常者72例(正常组)占38.7%。结直肠息肉的病理主要为管状腺瘤,占78.9%(71/90),锯齿状腺瘤占2.2%(2/90),增生性息肉占3.3%(3/90),炎性息肉占3.3%(3/90)。进展期息肉和非进展期息肉的直径、是否有蒂及大体分型比较差异均有统计学意义(P均<0.05)。息肉组和正常组病史(慢性腹泻、慢性便秘、黏液血便、慢性阑尾炎或阑尾切除史、胆囊切除史或慢性胆道疾病史、息肉病史、家族肠癌病史)比较差异均无统计学意义(P均> 0.05),女性、年龄和饮酒史是结直肠息肉的独立危险因素。结论广州增城地区的腺瘤检出较高,大肠癌筛查的获益大,深入到农村或者经济不发达的地方进行大肠癌筛查可能获益更大。
Objective To analyze the fine colonoscopic screening results in patients with positive colon cancer screening in the community and explore the importance of colon cancer screening.Methods The colonoscopic results and clinical data of 186 patients with positive colon cancer during the community-based screening in Zengcheng district of Guangzhou were retrospectively analyzed.Results Among 186 patients positive for colon cancer,the detection rate of colorectal polyps was 43.4%(90/186),39.2%(73/186) for the adenoma and 3.8%(7/186) for the colorectal cancer,respectively.Of the 186 cases undergoing colonoscopy,114 with abnormal lesions accounted for 61.3%(114/186),and 72 normal cases(normal group) accounted for 38.7%.Among them,those with progressive polyps accounted for 29.0%(33/114),50.0%(57/114) for the non-progressive polyps,14.9%(17/114) for the non-neoplastic lesions,and 6.1%(7/114) for the malignant tumors.The colorectal polyps was mainly pathologically diagnosed as tubular adenoma(78.9%,71/90),2.2%(2/90) for the serrated adenoma,3.3%(3/90) for the hyperplastic polyps,and 3.3%(3/90) for the inflammatory polyps.Differences between the diameter of advanced polyps and non-progressive polyps,whether they are pedicled,and the general type are statistically significant(all P < 0.05).There was no statistically significant difference in the history(chronic diarrhea,chronic constipation,mucus bloody stools,chronic appendicitis or appendectomy,history of cholecystectomy or chronic biliary tract disease,history of polyps,family history of intestinal cancer) of polyps and normal groups(all P > 0.05).Women,age and drinking history were the independent risk factors for colorectal polyps.Conclusions The detection rate of adenoma is relatively high in Zengcheng District of Guangzhou.Colorectal cancer screening brings enormous benefits,which can bring more benefits to the rural or economically underdeveloped areas.
作者
冯正平
梁杏花
李海艳
Feng Zhengping;Liang Xinghua;Li Haiyan(Department of Gastroenterology,Zengcheng District People’s Hospital of Guangzhou,Guangzhou 511300,China)
出处
《新医学》
2020年第8期637-641,共5页
Journal of New Medicine
关键词
大肠癌筛查
肠镜精筛
内镜特点
结直肠息肉
问卷调查
Colon cancer screening
Fine colonoscopic screening
Endoscopic characteristics
Colorectal polyps
Questionnaire survey
