摘要
目的系统评价无症状高龄老年人群结肠癌筛查效能。方法检索Pubmed与Embase数据库；检索主题词为colorectal neoplasms, adenoma, screening, elderly, colonoscopy；提取高龄和非高龄人群结直肠腺瘤、进展期腺瘤及结直肠癌（CRC）的检出率；采用RevMan5．3软件进行Meta分析。结果纳入文献12篇，共计患者312111例（25107例高龄者，287004例非高龄者），总的高龄人群进展期腺瘤检出率（AADR）为9．97％，腺瘤检出率（ADR）为11．33％，CRC检出率1．79％。Meta分析结果显示，无症状高龄人群AADR较非高龄相对危险度（RR）为1．57，95％C／：1．51—1．64，P〈0．00001；ADR的RR为1．22，95％C／：1．19～1．25，P〈0．00001；CRC检出率RR为2．6，95％C／：2．34—2．90，P〈0．00001；差异均有统计学意义。无症状高龄老人AADR、ADR、CRC检出率均高于非高龄人群。结论无症状高龄老人进展期腺瘤及CRC检出率较非高龄者明显增加，但缺乏筛查并发症及对其生存期是否延长的相关证据。因此，高龄老人是否需要筛查结肠癌仍待进一步研究。
Objective To systematically assess the efficiency of colonoscopy screening for the a- symptomatic elderly. Methods A search was performed to identify studies related to colonoscopy screening for the aged in Pubmed and Embase. The key words used for the search included colorectal neoplasm, adeno- ma, screening, elderly, and colonoscopy. The detection rate of colorectal adenomas, advanced adenomas, colorectal cancer in the elderly and non-elderly were extracted. The studies were evaluated and analyzed by software RevMan 5.3. Results Twelve studies involving 312 111 eases were included（25 107 elderly and 287 004 non-elderly）. The total AADR of the elderly was 9. 97% ,ADR was 11.33% ,while CRC detection rate Was 1.79%. The meta-analysis showed that there were significant differences in the AADR（ RR = 1.57, 95 % CI： 1.51-1.64）, ADR （RR = 1.22, 95 % CI： 1.19-1.25 ） and CRC detection rate （ RR = 2. 6,95 % C[： 2. 34-2. 90） between the elderly and the younger patients （P 〈 0. 000 01 ）. The detection rate of AADR, ADR, CRC in the elderly were significantly higher than the non-elderly. Conclusion The elderly have high- er AADR and CRC detection rate than the younger. But further studies are needed because life expectancy and complications are factors that need to be considered for screening.
出处
《中华消化内镜杂志》
北大核心
2015年第10期653-658,共6页
Chinese Journal of Digestive Endoscopy
基金
阿司匹林在阿尔兹海默病中的抗炎机制研究（201440022）
第二军医大学优秀青年学者项目及上海市科技启明星计划（A类）（14QA1404800）
