直肠指检和肠镜检查在直肠癌和大肠癌筛查中的效果评价  

Assessment of the Effectiveness of Digital Rectal Examination and Enteroscope Examination in Rectal and Colorectal Cancers Screening Based on Common Population

作　　者：何锋[1] 沈永洲[1] 蔡善荣[2] 曹泮悬 马浩清 王征远[1] 沈高飞[1] 

机构地区：[1]浙江省海宁市中医院,浙江海宁314400 [2]浙江大学医学院附属二院肿瘤研究所,浙江杭州310009

出　　处：《中国肛肠病杂志》2010年第2期9-11,共3页Chinese Journal of Coloproctology

摘　　要：为评价直肠指检和肠镜检查在普通人群直肠癌和大肠癌筛查中的效果，本研究以问卷调查和免疫法大便隐血试验（FOBT）检查为初筛，直肠指检和肠镜检查为复筛，作为大肠癌筛查方案，以海宁市普通人群7831例初筛人群中1015例高危人群的直肠指检和肠镜检查结果为样本，定义距肛门≤10cm且直径≥1．0cm的肿块为直肠指检能够发现，距肛门〉10cm的肿块和肿块虽距肛门≤10cm但直径〈1．0cm，为直肠指检所不能发现。分析直肠指检和肠镜检查对直肠肿瘤和大肠肿瘤的检出效果。结果显示，距肛门≤10cm肿瘤占筛查发现的大肠肿瘤总例数的31．3％（56／179）；经直肠指检筛查，直肠肿瘤和大肠肿瘤的检出率分别为2．6％（3／115）和1．7％（3／179），直肠癌和大肠癌的检出率分别为50．0％（2／4）和25．0％（114），进展性直肠肿瘤和大肠肿瘤的检出率分别为40．0％（4／10）和14．8％（4／27）。结果表明，直肠指检在普通人群的直肠癌检查中至关重要，对大肠癌的筛查需进行肠镜检查。The objective of the study was to assess the effectiveness of digital rectal examination（DRE） and enteroscope examination in rectal and colorectal cancers screening based on common population. Questionnaire plus immunochemical fecal occult blood test（FOBT） were conducted as the primary screening（7831 people in Haining municipality）,DRE and colonoscopy as the second screening（1015 cases were defined as high-risk population）. Thoses neoplasms which were located ≤10cm to the anus and which were ≥1.0cm in diameter were included in the assessment. The digital rectal examination for the neoplasms located 10cm to the anus or located ≤10cm but 〈1.0cm in diameter to the anus was not discovery. The screening outcome of DRE and colonoscopy for rectal and colorectal neoplasms was analyzed. As results, the noeplasms located ≤10cm to the anus accounted for 31.3 % （56/179） of the total screened out neoplasms the detectable rate of DRE in rectal and colorectal neoplasm screening were 2.6% （3/115） and 1.7% （3/179） respectively,in rectal and colorectal carcinoma screening were 50.0 % （2/4） and 25.0 % （1/4） respectively, and in progressive rectal and colorectal neoplasm screening were 40.0%（4/10） and 14.8% （4/27） respectively. It is concluded that DRE is an important method in rectal carcinoma of common population, for colorectal carcinoma screening must be enteroscope.

关 键 词：结直肠肿瘤 直肠指检 肠镜检查 筛查结果 

分 类 号：R735.37[医药卫生—肿瘤] R574[医药卫生—临床医学]