胃癌患者术前结直肠镜检的临床意义

Significance of preoperative colonoscopy in patients with gastric cancer

目的探讨胃癌患者术前结直肠镜检的临床意义。方法比较326例胃癌患者(胃癌组)术前行肠镜检查和同期体检行肠镜检查者326例(对照组)结直肠新生物(CRN)的发生率,分析胃癌患者CRN与年龄、性别、CEA、CA19-9、肿瘤部位、TNM分期、分化程度和病灶数目的关系。结果胃癌组CRN和结直肠癌检出率为36.8%和3.4%,高于对照组的11.3%和0.6%(P<0.05)。胃癌组患者CRN的危险因素为年龄≥65岁、男性和多发胃癌(P<0.05);CRN与胃癌TNM分期、分化程度以及肿瘤位置无明显相关(P>0.05)。结论胃癌患者术前有必要行肠镜检查,尤其是年龄≥65岁、男性及多发胃癌患者合并结直肠新生物的风险高。

Objective To investigate the significance of preoperative colonoscopy in the patients with gastric cancer.Methods The incidence of colorectal neoplasm（CRN）by colonoscopy before operation was compared between 326 patients with gastric caner（group A）and 326 healthy people underwent colonoscopy（group B）.The association of CRN and age,gender,serum CEA and CA19-9,tumor location,TNM stage,differentiation and number of lesions was analyzed in group A.Results The detection rates of CRN and colorectal cancer in group A were 36.8% and 3.4%,respectively,which were higher than 11.3%and 0.6%in group B（P〈0.05）.The risk factors for CRN in group A were age≥65,male and multiple gastric cancers（P〈0.05）.The incidence of CRN in group A was not remarkably related to TNM stage,differentiation and tumor location（P〉0.05）.Conclusion It is necessary for gastric cancer patients to undergo colonoscopy before operation,especially in those aged nore than 65 years old,male and with multiple gastric cancers.