内镜技术在提高肠道腺瘤检出率中的应用  

Endoscopic techniques for improving colorectal adenoma detection:Recent progress

作　　者：许吉成[1] 刘冰熔[1] 

机构地区：[1]哈尔滨医科大学附属第二医院消化内科,黑龙江省哈尔滨市150086

出　　处：《世界华人消化杂志》2012年第32期3118-3123,共6页World Chinese Journal of Digestology

摘　　要：结直肠癌(colorectal cancer,CRC)是全球范围内最常见的恶性肿瘤之一,其大多数由腺瘤等癌前病变进展而来.因此,及早发现并切除肠道腺瘤是预防其癌变的关键.目前,结肠镜检查被公认为是诊断和治疗肠道病变的金标准,但常规肠镜检查对病灶有一定漏诊率.Rex等研究表明腺瘤≥1cm时漏诊率为6%,6-9mm时为13%,≤5mm时为27%;并且右半结肠腺瘤的漏诊率要高于左半结肠.肠镜下漏诊腺瘤或恶性肿瘤势必会增加外科手术率和患者死亡率.因此,为了提高肠镜下腺瘤的检出率,国内外的一些学者作了大量的研究工作,并取得了一定的成果.本文就提高内镜下肠道腺瘤检出率的一些技术和方法作一简要综述.Colorectal cancer（CRC） is one of the most common malignant neoplasms worldwide and develops mostly from precancerous lesions such as colorectal adenomas.Therefore,early detection and resection of colorectal adenomas is key to preventing CRC.At present,colonoscopy is acknowledged as the gold standard for the diagnosis and treatment of colorectal lesions;however,conventional colonoscopy is still associated with a certain rate of missed lesions.It is reported that the missed detection rate is 6% when adenomas are more than 1 cm,13% for adenomas 6-9 mm,and 27% for adenomas less than 5 mm.The missed detection rate for right colonic adenomas is higher than that for left colonic adenomas.The missed diagnosis of colorectal adenomas or malignant tumors invariably increases surgical rate and mortality.Currently,great efforts have been made to improve the detection rate of colorectal adenomas.This paper will briefly review recent advances in endoscopic techniques for improving the detection rate of colorectal adenomas.

关 键 词：腺瘤检出率 自发荧光内镜 透明帽辅助肠镜检查法 窄带成像技术 广角内镜 

分 类 号：R735.3[医药卫生—肿瘤]