两种动态监控筛查大肠癌及腺瘤性息肉的效果比较

To compare the effect of two dynamic monitoring screening colorectal cancer and adenomatous polyps

目的研究消化科门诊应用2种方式筛检大肠癌和腺瘤性息肉的优劣。方法将548例符合高危条件,其中粪潜血试验(fecal occult blood test,FOBT)与肠镜均未筛查出大肠癌或腺瘤样息肉的体检人群进行分组,每年进行二次FOBT,同时行结肠镜检查者为A组。不愿意行结肠镜检查者为B组,每年进行2次FOBT,若连续2次FOBT为阳性则劝其必须进行结肠镜检查。随访2年,比较2组患者监控1年后、2年后的FOBT阳性率、大肠癌及腺瘤样息肉检出率。结果监控1年后、2年后的FOBT阳性率、大肠癌及腺瘤样息肉检出率差异无统计学意义,2个组的人均筛查费用差异无统计学意义,A组患者筛查阳性者总治疗费用高于B组患者。结论在对大肠癌和腺瘤性息肉的动态监控筛检中,若受检者不愿接受直肠镜检查,可以每年进行2次FOBT,若连续2次FOBT为阳性则劝其必须进行结肠镜检查,可降低体检经济负担,有利于与体检者的沟通。

Objective To study the advantages and disadvantages of two methods for screening colorectal cancer and adenomatous polyp in digestive clinic. Methods Five hundred and forty-eight patients who met high risk conditions but who screened for negative colorectal or adenomatous polyps were grouped,in which group A underwent two times of fecal occult blood test(FOBT) each year and underwent colonoscopy at the same time. Those who deny colonoscopy underwent two times of FOBT every year for the B group. If two consecutive FOBT tests were positive,they were advised to have a colonoscopy. After 2 years of follow-up,the positive rates of FOBT,colorectal cancer and adenomatous polyp were monitored in two groups after 1 years and 2 years. Results The positive rate of FOBT,colorectal cancer and adenomatous polyp were not significantly different between 1 years and 2 years after monitoring. There was no significant difference in the average cost of screening between the two groups,and the total cost of treatment in the A group was significantly higher than that in the B group. Conclusion In the dynamic monitoring and screening for colorectal cancer and adenomatous polyps,if subjects were unwilling to accept colonoscopy,can be two FOBT per year,if two consecutive FOBT positive is advised which must colonoscopy examination can reduce the economic burden,is conducive to the body and the subjects of communication.