南昌地区结肠癌高危因素与结肠病变的相关性研究

Study on the correlation between high risk factors of colon cancer and colonic lesions in Nanchang area

目的通过对南昌地区有结肠癌高危因素的人群进行结肠镜筛查,了解结肠癌高危人群结肠癌前病变发生率,为结肠癌的早期诊断、治疗提供依据。方法从2012年1月~2016年1月参加南昌市各社区组织健康体检的人群共计1128例选出符合入选标准的结肠癌高危因素人群158例,均行电子结肠镜及病理检查。统计不同年龄组高危人群高危因素(结肠瘤癌家庭史、长期饮酒、肠息肉史、慢性便秘、慢性腹泻、黏液血便、精神病史、阑尾疾病、大便隐血阳性)的高危率、结肠镜检率、息肉检出率、重度不典型增生人数及高危因素与重度不典型增生的相关性。结果不同年龄组高危人群极高危率最高在50~59、60~69岁两组,分别为17.94%、18.35%。最低在20~29岁年龄组,为7.69%。高危因素比例、结肠镜检人数在黏液血便及大便隐血阳性中最高,分别为29.11%与30.38%、93.47%与100.00%。息肉检出率在阑尾疾病、大便隐血阳性中最高,均为66.67%。高危因素与重度不典型增生的相关性检验结果显示,结肠瘤癌家庭史、肠息肉史、黏液血便、大便隐血阳性与重度不典型增生成正相关(P<0.05)。结论南昌地区有结肠癌高危因素人群中黏液血便及大便隐血阳性的人群中重度不典型增生检出率最高,是结肠癌的重要高危因素,这对结肠癌的早期预防起积极作用。

Objective To investigate the incidence rate of precancerous lesions for colon cancer in high-risk population of colon cancer through the colonoscopy screening the population having high-risk factors of colon cancer in Nanchang area to provide the basis for the early diagnosis and treatment of colon cancer.Methods 158 cases having the high-risk factors of colon cancer and meeting the inclusion criteria were selected from 1128 healthy volunteers enrolled in the various community of Nanchang City from January 2012 to January 2016.158 cases were given the electron colonoscopy and pathology examination.The high risk rate of high-risk factors （family history of colon cancer and tumor, long-term drinking,history of polyps,chronic constipation,chronic diarrhea,bloody mucus,mental illness,disease of appendix,positive fecal occult blood） for high risk population of different age groups and the rate of colonoscopy,the detection rate of polyps and the number of severe atypical hyperplasia,and the correlation between high risk factors and severe atypical hyper- plasia were counted.Results The highest risk rate of high risk population in different age groups was 50-59 and 60-69 years old,and it was accounting for 17.94% and 18.35% respectively.The lowest in the 20-29 age group （7.69%）.The proportion of high-risk factors,colonoscopy proportion was the highest in bloody mucus and fecal oceuh blood positive, and it was accounting for 29.11% and 30.38%,93.47% and 100.00% respectively.The detection rate of polyps was the highest in appendix disease,fecal occult blood positive,and it was both accounting for 66.67%.The correlation between high risk factors and severe atypical hyperplasia showed that there was a positive correlation between the incidence of family history of eolorectal cancer, intestinal polyps,mucus bloody stool,fecal occult blood and severe atypical hyperplasia （P〈0.05）.Conclusion The detection rate of severe atypical hyperplasia in high-risk groups with visceral bloody stool and fecal occult blood is the highest,they are important risk factor of colon cancer, which plays a positive role in the early prevention of coloreetal cancer.