互补序贯初筛方案对提高大肠癌筛检率的价值

Effect of the Combinated Sequent Program for Screening Colorectal Carcinoma

目的 :为进一步提高无症状人群普查中大肠癌的检出率 ,降低普查费用。方法 :在既往序贯粪隐血筛检方案 (S方案 )、粪隐血与微量白蛋白互补方案 (SA方案 )的基础上 ,探索了互补序贯筛检方案 ,即粪隐血与微量白蛋白互补→肠道脱落细胞序贯方案 (SAD方案 )。结果 :经 392例已知患者验证 ,SAD方案大肠癌检出敏感性显著高于S方案 (P<0 .0 1) ,与SA方案无显著差异 (P >0 .0 1) ,特异性显著高于SA方案 (P <0 .0 1) ,在各方案中每检出 1例大肠癌患者所用经费最低 ( 32 3.7元 /例 )。结论 :SAD方案筛检大肠肿瘤敏感性高 ,特异性强 ,效 /价比最优。

Purpose: In order to make further improvement on the positive rate of colorectal carcinoma from asymtomatic population, and decrease the fee of general surveg. Methods: On the basis of the program of sequent fecal occult blood test(S), and the program combined sequent fecal occult blood test with micro-alhumin test(SA), we studied a new scrceing program that is S+SA+exfoliative cell DNA image analysis (SAD), the new program has beencxamined in the patients whose diagnosis have been made by endoscopy. Results: In the group of the new program the sensetivity is obvious higher than S(P<0.01), the specificity is significant higher than SA, the cost for scrceing a cancer is lower ($323.7/cancer) than the others. Conclusion: The result indicated that the program of SAD is a good program with higher sensetivity, higher specificity and well cost efficiency.