结肠镜普查及随访对老年人早期结直肠癌的诊断价值

Evaluation of the clinical screening and the follow-up for early colorectal cancer by colonoscopy in the elderly

目的 通过对老年人进行结肠镜临床普查及随访 ,提高老年人结直肠癌的防治水平。 方法 结合每年查体对 2 196例 6 0～ 89岁老年人进行结肠镜临床普查及随访 ,结肠镜随访 1740例 ,随访率为 79 2 %。 结果 共检出结直肠癌 5 2例 ,检出率为 2 4% ,早期结直肠癌 19例 ,占36 5 % ,结肠镜随访中检出早期结直肠癌 9例 ,占随访检出结直肠癌 2 0例的 45 0 %。结直肠癌手术切除率及术后 5年生存率分别为 97 7%和 80 9%。结肠镜插镜成功率为 98 9% ,并发症的发生率为0 0 5 %。 结论 开展老年人结肠镜临床普查及随访 ,使结直肠癌及癌前病变———腺瘤性息肉患者得到了早期诊治 ,提高了早期结直肠癌的检出率及结直肠癌的Ⅱ级防治水平。

Objective To evaluate the importance of clinical screening and follow up by direct colonoscopy for colorectal cancer at an early and curable stage. Methods There were 2 196 elderly people aged between 60 to 89 years. The clinical screening by direct colonoscopy was performed according to the protocol. 1 740 of 2 196(79.2%) patients were followed up every year. Results Fifty two elderly persons were found to be colorectal cancer patients by colonoscopy, with the detectable rate being 2.4%. Nineteen were diagnosed early stage colorectal cancer, accounting for 36.5% of the detected colorectal cancer. Nine among the followed up cases were detected early colorectal cancer, accounting for 45 0% of the detected colorectal cancer. The resectable rate and the 5 year survival rate was 97 7% and 80 9% for colorectal cancer, respectively. 98 9% of the cecum intubation cases was successful. The incidence of complication for colonoscopy was 0 05%. Conclusions By clincal colonscopy screening and follow up study for colorectal cancer and precancerous changes in the elderly, the patients with adenomatoid polyps were early diagnosed and treated, so it raised the detectable rate of early colorectal cancer and the level of grade prevention of colorectal cancer.