摘要
目的探讨基于医院就诊人群大肠癌及癌前病变伺机性筛查策略。方法 对2868例解放军281医院门诊就诊患者进行大肠癌及癌前病变危险因素调查,筛选出高危患者后,建议高危患者接受结肠镜检查。分析高危患者的检出情况、大肠癌及癌前病变的检出率。结果 共筛选出高危患者511例(17.8%),男性高危患者检出率(20.5%)显著高于女性(13.9%)(P〈0.001);不同年龄段高危患者检出率有显著差异(P=0.002),随年龄增加,检出率随之增加。共检出大肠癌78例,不同年龄患者大肠癌检出率不同(P=0.002),其中年龄在61-70岁检出率最高,18-30岁最低;不同高危因素下,大肠癌检出率亦不相同(P〈0.001),其中因素(3)、(4)、(2)排在前3位。共检出大肠癌前病变236例,不同年龄调查者大肠癌前病变检出率明显不同,其中年龄在51-60岁检出率最高,18-30岁最低。而不同高危因素下大肠癌前病变的检出率无统计学差异(χ2=9.826,P=0.132)。结论针对医院就诊患者的大肠肿瘤的伺机性筛查既能筛查出高危患者,同时又能早期发现大肠癌或癌前病变,对大肠癌的防治意义重大,是一种可行的大肠癌筛查策略。
Objective To explore the opportunistic screening strategies for large intestinal carcinomas and precancerosis in patients who visited a hospital. Methods An investigation in risk factors of large intestinal carcinomas and precancerosis was made on 2868 patients who visited Department of Outpatient of Hospital 281 of PLA. High-risk patients were screened out and suggested to receive colonoscopy. The results of screening and the discovery rate of large intestinal carcinomas and precancerosis in the patients were analyzed. Results A total of 511 high-risk patients (17.8%) were screened out. It was found that the discovery rate in male high-risk patients (20.5%) was significantly higher than that in female high-risk patients (13.9%) (P 〈 0.001); there was significant difference in the discovery rate among high-risk patients at different ages (P = 0.002) and the discovery rate increased with age. Large intestinal carcinomas were discovered from 78 patients. The discovery rate of large intestinal carcinomas in patients of different ages differed (P = 0.002): it was the highest in the patients aged 61-70 and the lowest in those aged 18-30; the discovery rate also differed under different high-risk factors (P 〈 0.001), among which the discovery rate under factors ③, ④ and ② ranked the top three respectively. Precancerosis were discovered from 236 patients. The discovery rate of precancerosis in patients of different ages differed greatly: the discovery rate was the highest in the patients aged 51-60 and the lowest in those aged 18-30. The discovery rates of precancerosis, however, had no significant difference under different high-risk factors (X^2 = 9.826, P = 0.132). Conclusion Through opportunistic screening, high-risk colorectal tumor in patients who visited a hospital can be screened out and large intestinal carcinomas and precancerosis can be discovered in advance. This is of great significance for the prevention and cure of large intestinal carcinomas and is a feasible screening strategy for large intestinal carcinomas.
出处
《西南国防医药》
CAS
2016年第10期1181-1184,共4页
Medical Journal of National Defending Forces in Southwest China
关键词
大肠癌
癌前病变
伺机性筛查
large intestinal carcinomas
precancerosis
opportunistic screening