大肠癌高危人群结肠镜检查追踪随访

Colonoscopy follow up in peoples with high risk colorectal cancer

目的大肠癌在消化道肿瘤中预后较好,如能较早的发现和及时治疗,完全可以根治。方法对1125例大肠癌高危人群进行结肠镜的追踪随访检查。结果发现大肠癌37例(3.3%),其中28例(75.7%)为无淋巴结转移的早期癌,发现癌前期病变—大肠腺瘤215例(19.1%)。结论结肠镜对大肠癌高危人群进行定期追踪检查是发现早期大肠癌和癌前期病变—腺瘤最方便、最安全、最简便的方法。

Objective To supervise the colonoscopy following up in the high risk colorectal cancer patients are good to find out early stage cancer and adenoma in time and prevent the latter to evolve in to cancer. Methods From Aug. 1995 to Mar. 2000, 1 125 cases of high risk colorectal cancer have received the colonoscopy .Of them, 353 cases who have symptoms after having the physical examination in clinics; 125 cases have the colorectal cancer family history without any symptoms; 386 cases have had operated on the colorectal cancer; and 261 cases with the colorectal adenoma after high frequency electrotomy under endoscopy in one year. Results In 353 cases, 52 cases (14.7%) with adenoma and 17 cases (4.8%) with colorectal cancer are found, and 12 cases (70.5%)of the latter are of early stage cancer without any lymph node metastasis. Among the 125 cases there were 26 cases (21.6%) with adenoma, 4 cases (3.2%) with colorectal cancer and 2 cases (1.6%) with adenoma early stage cancer. Among the latter 6 cases, 5 cases are of the early stage cancer without any lymph node metastasis. Of the 386 cases , 81 cases (20.9%) of adenoma, 3 cases (0.7%) of the third primary cancer, and 11 cases (2.8%) of second primary cancer were found in which 11 cases (78.5%) are of the early stage cancer without any lymph node metastasis. In 261 cases there were 56 cases (21.4%) with adenoma, among them, 41 cases (73.2%) are the newly found adenoma with diameter < 1cm ,and the rest 15 cases(26.8%) with adenomas >1cm in diameter were missed in the first colonoscopy.Conclusion A total of 1 125 cases with high risk colorectal cancer were examined by colonoscopy, it was found 37 cases (3.3%) with carcinoma, in which 28 cases (75.7%) with early cancer of no lymph node metastasis, and other 215 cases (19.1%) with adenoma.