上海市宝山地区社区居民大肠癌筛查结果分析  

Analysis on screening results of colorectal cancer among residents in Shanghai Baoshan area

作　　者：李娜娜 倪湘云 孟祥军[1] 朱黎明[1] LI Nana;NI Xiangyun;MENG Xiangjun;ZHU Liming(Department of Gastroenterology,the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200000,China)

机构地区：[1]上海交通大学医学院附属第九人民医院消化内科,上海200000

出　　处：《现代肿瘤医学》2022年第1期134-139,共6页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:81872419)。

摘　　要：目的:分析上海市宝山地区社区居民大肠癌筛查结果,探究国内大肠癌筛查模式在大肠癌诊断中的临床意义。方法:选取2017年06月至2019年06月上海市宝山地区按照社区大肠癌筛查流程完成筛查且评定为初筛阳性,并至我院完成全结肠镜诊断性检查且获取检查结果的人群作为研究对象,共769例。根据肠镜结果,分成病变组和正常组,分析两组之间性别和年龄的差异。病变组根据肠镜病理结果,分析大肠癌组、异型增生组、腺瘤组、良性息肉组性别、年龄以及病变大小、数目、位置的差异,并分析危险度评估、FOBT及两者并联筛查的效益。结果:本研究共纳入769例,正常组393例,病变组376例,总病变检出率48.8%。病变组中大肠癌12例,检出率1.6%;异型增生组31例,检出率4.0%;腺瘤组247例,检出率32.1%;良性息肉组66例,检出率8.6%;肠炎和其他诊断20例。不同性别、年龄之间病变检出率差异有统计学意义(P<0.05),不同年龄之间良性息肉检出率差异有统计学意义(P<0.05)。12例大肠癌在病变大小方面差异有统计学意义(P<0.05),病变直径均≥1 cm。247例腺瘤在大小、位置分布方面差异有统计学意义(P<0.05),病变以左半结肠直径小于1 cm为主。66例良性息肉在大小、数目、位置分布方面差异均有统计学意义(P<0.05),病变以左半结肠多发、直径<1 cm为主。以肠镜检查为金标准,初筛判定的灵敏度为87.9%,高于FOBT的79.2%,且假阴性率(12.0%)较低,低于FOBT的20.8%。结论:国内现阶段实行的社区大肠癌筛查模式有效地提高了大肠癌及癌前病变的检出率,在大肠癌可干预的阶段进行二级预防,能够降低其发病率和死亡率。Objective:To analyze the results of colorectal cancer screening in Shanghai Baoshan area and explore the clinical significance of screening mode in diagnosis of colorectal cancer.Methods:The population who evaluated the positive result according to the community colorectal cancer screening and received colonoscopy examination from June 2017 to June 2019 in Shanghai Baoshan area,was enrolled.All of 769 cases were included.The population was divided into the normal group and the lesion group according to the results of colonoscopic diagnosis.The differences in gender and age between the two groups were analyzed.The lesion group was further divided into four groups according to the pathological results of colonoscopy:Colorectal cancer group,dysplasia group,adenoma group and benign polyp group.The differences in gender,age,lesion size,number and location were analyzed in those four groups.The benefits of risk assessment,FOBT testing,and parallel screening were also studied.Results:A total of 769 cases were included in this study,393 cases in the normal group and 376 cases in the lesion group,and the total lesion detection rate was 48.8%.The rate of colorectal cancer,dysplasia,adenoma,benign polyp detection was 1.6%,4.0%,32.1%,and 8.6%,respectively.There was statistically significant difference in the detection rate of lesions between different genders and ages(P<0.05).There was statistically significant difference in the detection rate of benign polyps between different ages and in the size of the 12 cases of colorectal cancer(P<0.05).There was statistically significant difference in size and location distribution of 247 cases of adenoma(P<0.05),the lesion was mainly in left hemicolon with a diameter less than 1 cm.There was statistically significant difference in size,number,and location distribution of 66 cases of benign polyp(P<0.05).The lesions were mainly in left hemicolon,multiple,and<1 cm in diameter.With colonoscopy as the gold standard,the sensitivity of primary screening(positive for either of the two)was 8

关 键 词：大肠癌 癌前病变 筛查 

分 类 号：R735.34[医药卫生—肿瘤]