哈尔滨市2012-2015年度结直肠癌高风险人群样本筛查分析  

Analysis of screening for colorectal cancer high-risk groups in Harbin, China 2012-2015

作　　者：宋达为 黄睿[1] 马天翼[1] 陈瑛罡[1] 李佳英[1] 王锡山[1] 

机构地区：[1]哈尔滨医科大学附属第二医院结直肠肿瘤外科哈尔滨医科大学大肠癌研究所,150086

出　　处：《中华胃肠外科杂志》2016年第10期1139-1143,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：黑龙江省医学科学院科研计划项目（201504）;哈尔滨医科大学科研基金（KYBS2015-30）

摘　　要：目的评价2012-2015年哈尔滨市城市高风险人群结直肠癌筛查结果的意义。方法根据“国家城市癌症早诊早治结直肠癌项目（国家卫生和计划生育委员会2014公益性行业科研专项（201402003）”，动员哈尔滨市内40～69岁的常住户籍居民，应用国家癌症中心统一制定的防癌风险评估问卷进行评估．对评估发现癌症的高风险人群行包括结肠镜检查在内的结直肠癌临床筛查，通过结果探讨结直肠癌筛查的效果。结果2012-2015年间，哈尔滨市各城区均顺利完成了年度结直肠癌城市早诊早治项目。通过风险评估检出3017人，实际参与筛查者2996人，其中男1367例，女1629例，男女比例为1．0：1．2；年龄40～69（53．3±7．1）岁。2996人中共筛查出肠息肉患者1158例（38．7％），其中≤60岁者占36．6％（901／2465），〉60者占48．4％（257／531），两组比较，差异有统计学意义（x^2=19．19，P〈0．01）；男性占47．6％（651／1367），女性占31．1％（507／1629），两组比较，差异有统计学意义（x^2=85．33，P〈0．01）。有141例肠息肉患者予以肠镜下取标本进行了病理检查，发现结直肠癌11例，占全部筛查人数的0．4％（11／2996）；经建议，11例患者均进行了手术治疗，术后病理皆为早期腺癌。另外，141例中共检出管状腺瘤97例，分布睛况为盲肠2例（2．1％），升结肠14例（14．4％），横结肠12例（1214％），降结肠15例（15．5％），乙状结肠35例（36．1％），直肠19例（19．6％）。结论随着年龄的增加，样本人群息肉的患病率明显上升。男性肠息肉的发生率相较女性的发生率高。腺瘤主要集中在脾曲以下的远端结肠和直肠，以乙状结肠为主。早期对高风险人群的筛查可以及早发现癌前病变及癌症，从而使患者在疾病早期就得到相应的治疗。Objective To evaluate the result of colorectal cancer screening for high-risk groups in Harbin, China from 2012 to 2015. Methods According to the Project of National Colorectal Cancer Screening in Urban Area, epidemiological investigation and cancer risk evaluation established by National Cancer Center were performed among 40-69 years old residents in Harbin. Questionnaires were issued to assess high-risk groups for clinical screening, including colonoscope examination. The results of colorectal screening were evaluated in detail. Results Project of Colorectal Cancer Screening in Urban Area was completed successfully from 2012 to 2015 in various districts of Harbin. The accomplishment of high-risk assessment included 3 017 people, while 2 996 people received the clinical screening, including 1 376 males and 1 629 females, from 40 to 69 （53.3 ± 7.1） years old. Among 2 996 people, 1 158 cases of colorectal polyps （38.7%） were screened, including 36.6%（901/2 465） cases of age 〈 60 and 48.4%（257/531） cases of age 〉 60 years old with significant difference （x^2 = 19.19, P 〈 0.01）, and 47.6% （651/1 367） cases of male and 31.1%（507/1 629） cases of female with significant difference （x^2= 85.33, P 〈 0.01）. Of 1 158 polyps patients, 141 received the pathological examination and 11 patients were diagnosed as colorectal cancer, accounting for 0.4% of overall screening people （11/2 996）. All these 11 patients underwent operation by advice and the postoperative pathology results all indicated early adenocarcinoma. Furthermore, among 141 polyps patients, 97 cases of tubular adenoma were found, which were distributed as follows： 2 cases of cecum （2.1%）, 14 cases of ascending colon （14.4%）, 12 cases of transverse colon （12.4%）, 15 cases of descending colon （15.5%）, 35 cases of sigmoid colon （36.1%） and 19 cases of rectum （19.6%）. Conclusion With the increase in age, the risk of colorectal polyps is significantly elevated. The males have higher incidence of co

关 键 词：结直肠肿瘤 肠息肉 管状腺瘤 筛查 

分 类 号：R735.34[医药卫生—肿瘤]