结直肠腺瘤发病率的单中心回顾性研究

Single-center retrospective study on the incidence of colorectal adenomas

目的了解2014~2015年本院内窥镜中心结肠镜检查腺瘤发病率的特点,并比较<50岁年轻患者的腺瘤发病率变化。方法回顾性分析2014年1月~2015年12月完成的全结肠镜的人口学特点和结直肠镜腺瘤检出情况,分析接受全结肠镜检查患者中腺瘤发病率的特点。结果 2014年1月~2015年12月,本中心完成全结肠镜检查共计10812例。接受结肠镜检查患者的平均年龄(45.4±13.4)岁。结肠镜检查的不良事件为4例(其中包含出血、穿孔、肠扭转)。10812例患者中年龄<50岁占66.4%(7180/10812),2014年患者中年龄<50岁占66.3%,2015年患者中年龄<50岁占66.5%,比较差异无统计学意义(P>0.05)。结肠腺瘤的总体发病率为21.4%,2014年结肠腺瘤总发病率为18.9%(886/4688),2015年结肠腺瘤总发病率为23.4%(1430/6124),2年间结肠腺瘤发病率比较差异具有统计学意义(χ2=31.259,P<0.01)。2014年检查患者中50岁以下年轻患者结肠腺瘤的发病率为13.0%(405/3108),而2015年50岁以下年轻患者结肠腺瘤的发病率为14.9%(607/4072),比较差异具有统计学意义(χ2=5.112,P<0.05)。结论近2年(2014~2015年)结肠镜检查患者的结直肠腺瘤的整体发病率呈上升趋势,特别是50岁以下年轻患者结直肠腺瘤的发病率呈上升趋势,提示对于年轻患者非筛查监测的结肠镜检查具有相当的必要性。

Objective To know the incidence of adenoma by colonoscopy in our hospital during 2014~2015, and compare the incidence of adenoma in young patients under 50 years old. Methods The demographic characteristics of colostoscopy and the detection of colorectal adenoma were retrospectively analyzed from January 2014 to December 2015, and the incidence of adenoma in patients undergoing total colonoscopy was analyzed. Results From January 2014 to December 2015, this center completed 10812 cases of total colonoscopy. The mean age of patients receiving colonoscopy was（45.4±13.4） years old. There were 4 adverse events by colonoscopy（including hemorrhage, perforation and intestinal volvulus）. Among the 10812 patients, 66.4%（7180/10812） were〈 50 years old, and 66.3% of the patients were 50 years old in 2014, and 66.5% of the patients were 50 years old in 2015. Their difference had no statistically significant difference（P〉0.05）. The overall incidence of colon adenoma was 21.4%. The total incidence of colonic adenoma in 2014 was 18.9%（886/4688）. The total incidence of colonic adenoma in 2015 was 23.4%（1430/6124）. There was statistically significant difference in incidence of colonic adenoma between 2 years（χ^2=31.259, P〈0.01）. The incidence of colon adenoma in young patients under 50 years of age was 13.0%（405/3108）, which was 14.9%（607/4072） in 2015, and the difference had statistical significance（χ^2=5.112, P〈0.05）. Conclusion The overall incidence of colon adenoma in patients with colonoscopy was increasing in the past two years（2014 ~ 2015）, especially in young patients under 50 years old. It suggested that there is a considerable requirement for non-screening surveillance colonoscopy in young patients.