3798例粪便隐血阳性患者结直肠癌筛查的临床研究  

Clinical study of screening of colorectal cancer in 3 798 patients with positive fecal occult blood

作　　者：徐鹏 王一飞 张丽航 王善娟 XU Peng;WANG Yifei;ZHANG Lihang;WANG Shanjuan(Department of Gastroenterology,the Central Hospital of Jiading Affiliated to Shanghai Health Medical College,Shanghai 201800,China)

机构地区：[1]上海健康医学院附属嘉定区中心医院消化内科

出　　处：《国际消化病杂志》2020年第1期47-52,共6页International Journal of Digestive Diseases

基　　金：上海市嘉定区科学技术发展基金(2017ZD01)

摘　　要：目的探究上海市嘉定区粪便隐血阳性患者的结直肠息肉的临床特点及其流行病学规律。方法收集2014年12月至2016年12月因粪便隐血阳性来嘉定区中心医院接受结肠镜检查的患者的基本信息,包括性别、年龄、学历层次、息肉部位及病理结果等,进行统计学分析。结果发现息肉956例,活组织检查了523例;增生性和炎性息肉263例;腺瘤223例;结直肠癌37例。增生性和炎性息肉最多见,有蒂隆起型息肉的检出率最高。男性患病率明显高于女性,且主要表现在乙状结肠。息肉患者平均年龄(65.0±6.4)岁,62~71岁患者的患病率最高,占55.9%。乙状结肠为息肉最高发部位,直肠次之,分别占50.2%、16.5%,并且分别高发于距肛门20~25 cm以及10 cm以内处。息肉患病率以马陆镇最高,占36.7%,事业单位和机关的息肉患病率最高,占31.8%。自由职业者的活组织检查率最低,占46.5%。不同工作单位肿瘤性病变与非肿瘤性病变占比的差异无统计学意义。不同学历患者的息肉患病率差异无统计学意义。结论有必要加强重点地区和人群特别是无症状人群的结肠镜筛查,提高检出率以及活组织检查率,对预防结直肠癌的发生非常重要。Objective This paper is to explore the clinical characteristics and epidemiological rules of colorectal polyps in fecal occult blood positive patients in Jiading District of Shanghai.Methods The basic information of patients who received colonoscopy at the Central Hospital of Jiading from December 2014 to December 2016 due to positive fecal occult blood,including gender,age,education,polyp location,and pathological results,etc,was collected and statistically analyzed.Results Nine hundred and fifty-six cases of polyps were found,523 cases were biopsied;263 cases were proliferative and inflammatory polyps;223 cases were adenomas;and 37 cases were cancers.Proliferative and inflammatory polyps were the most common,and pedicled polyps were the most frequently detected.The prevalence of men was significantly higher than that of women,which was mainly manifested in sigmoid colon.The average age of patients with polyps was(65.0±6.4),and the prevalence was highest among patients aged 62 to 71,accounting for 55.9%.The sigmoid colon was the highest incidence site of polyps,followed by the rectum,accounting for 50.2%and 16.5%,respectively,with a high occurrence at 20 to 25 cm and within 10 cm from the anus,respectively.There was a highest prevalence of polyps in the people in Malu Township,accounting for 36.7%,and a highest prevalence in personnel in institutions and government agencies,accounting for 31.8%.The biopsy rate in freelancer was the lowest,accounting for 46.5%.There was no significant difference in the proportion of tumorous lesions and non-tumorous lesions in different organizations.There was no significant difference in the prevalence of polyps among patients with different educations.Conclusion It is necessary to strengthen colonoscopy screening in key areas and populations,especially asymptomatic populations,to improve the detection rate and biopsy rate,which is especially important in preventing the colorectal cancer.

关 键 词：粪便隐血 结直肠癌筛查 嘉定区 临床研究 

分 类 号：R735.34[医药卫生—肿瘤]