在体检人群中应用自测型免疫化学法粪便潜血试验筛查结直肠癌的结果分析  

Analysis of the results of screening for colorectal cancer based on self-administered fecal immunochemical test in physical examination population

作　　者：翟爱军[1] 武斌[1] 张续乾 杜丽娜 翟惠虹[2] 潘淑莉[1] 廖原 孟丽 逄丽丽 Zhai Aijun;Wu Bin;Zhang Xuqian;Du Lina;Zhai Huihong;Pan Shuli;Liao Yuan;Meng Li;Pang Lili(Depa r tment of Gastroenterology,No.731 Hospital of China Aerospace Science&Industry Corporation,Beijing 100074,China;Depar tment of Gastroenterology,Beijing Friendship Hospital,Beijing 100050,China)

机构地区：[1]中国航天科工集团七三一医院消化内科,北京100074 [2]首都医科大学附属北京友谊医院消化内科,北京100050

出　　处：《肿瘤综合治疗电子杂志》2020年第4期53-56,共4页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：首都发展基金(2018-3-1115);中国航天科工集团公司医疗卫生科研(2017-JKBZ-004)。

摘　　要：目的分析体检人群结直肠癌筛查结果,探讨自测型免疫化学法粪便潜血试验作为健康体检项目的意义。方法选择2019年4月至2019年12月在中国航天科工集团七三一医院体检中心进行健康体检的无症状人群为筛查对象。对符合纳入与排除标准的研究对象采用自测型免疫化学法粪便潜血试验进行初筛,初筛阳性者进行结肠镜检查。结合结肠镜和病理检查结果分析自测型免疫化学法粪便潜血试验的依从率、结直肠肿瘤检出率及阳性预测值。结果共有3239例体检者纳入本研究,其中1468例完成了自测型免疫化学法粪便潜血试验,总体依从率为45.32%(1468/3239)。男性和女性受检者的粪便潜血检测依从率分别为48.51%(832/1715)和41.73%(636/1524);不同年龄段(40~49岁、50~59岁、60~69岁、70~74岁)受检者的粪便潜血检测依从率分别为61.70%(820/1329)、43.59%(347/796)、31.02%(210/677)、20.82%(91/437)。共有160例潜血检测结果阳性,粪便潜血检测阳性率10.90%(160/1468)。男性受检者自测型免疫化学法粪便潜血试验的依从率显著高于女性受检者(P<0.01)。自测型免疫化学法粪便潜血试验的依从率随年龄增长逐渐下降,<60岁受检者的依从率显著高于≥60岁受检者(P<0.01)。在粪便潜血检测阳性的160例体检者中,92例完成全结肠镜检查,依从率为57.50%(92/160)。共检出结直肠肿瘤40例,包括结直肠癌1例,腺瘤39例。本次筛查结直肠肿瘤检出率为2.72%(40/1468),阳性预测值为43.48%(40/92),均显著高于本课题组前期筛查结果(分别为0.50%、16.92%)(均P<0.01)。结论自测型免疫化学法粪便潜血试验依从性好,结直肠肿瘤检出率和阳性预测值高,可作为体检人群结直肠癌筛查的有效工具。Objective To analyze the results of screening for colorectal cancer and explore the significance of self-administered fecal immunochemical test as a health checkup item.Method Asymptomatic population who had annual physical examination in No.731 Hospital of China Aerospace Science&Industry Corporation from April 2019 to December 2019 were enrolled into this study.All subjects who meet the inclusion and exclusion criteria were administrated with self-administered fecal immunochemical test,positive cases with the test were subjected to colonoscopy.Relevant results were analyzed in combination with colonoscopy and pathology data.Result Totally 3239 subjects were included in this study,including 1468 cases received self-administered fecal immunochemical test with a compliance rate of 45.32%(1468/3239).The compliance rates of fecal occult blood test males and females were 48.51%(832/1715)and 41.73%(636/1524),respectively.The compliance rates of fecal occult blood test in different age groups(40~49 years old,50~59 years old,60~69 years old,70~74 years old)were 61.70%(820/1329),43.59%(347/796),31.02%(210/677),and 20.82%(91/437),respectively.One hundred and sixty cases showed positive occult blood test results,and the positive rate of fecal occult blood test was 10.90%(160/1468).The compliance rate of self-administered fecal immunochemical test in male subjects was significantly higher than that in female subjects(P<0.01).The compliance rate of self-administered fecal immunochemical test decreased gradually with the increase of age,and the compliance rate of subjects<60 years old was significantly higher than those≥60 years old(P<0.01).Of the 160 physical examinations who tested positive for fecal occult blood,92 actually completed colonoscopy,and the compliance rate of colonoscopy was 57.50%(92/160).A total of 40 cases of colorectal neoplasms were detected,including 1 case of colorectal cancer and 39 cases of colorectal adenoma.The detection rate of colorectal neoplasms in this screening was 2.72%(40/1468)and the posi

关 键 词：结直肠肿瘤 免疫化学法粪便潜血试验 筛查 体检人群 

分 类 号：R735.34[医药卫生—肿瘤]