粪便隐血试验在大肠癌筛查中的意义

Significance of fecal occult blood test in colorectal cancer screening

大肠癌是常见的消化道恶性肿瘤之一,近年来我国大肠癌发病率呈上升趋势,通过筛查可以诊断出腺瘤、癌前病变和早期癌症,从而降低其发病率和死亡率,因此筛查对于大肠癌显得尤为重要。目前大肠癌检查主要分为粪便检查和结肠结构性检查,其中粪便检查包括粪便隐血试验、粪便脱落细胞检查及粪便基因学检查等,结肠结构性检查包括钡灌肠、结肠镜检查及计算机断层扫描结肠造影等。结肠镜检查被认为是大肠癌诊断的金标准,具有精准度高、可于发现癌前病变同时将其切除的优点,但因其为侵入性检查、需要肠道准备、检查时多引起被检查者明显不适和诊疗费用较高,其在筛查应用中受到了很大限制。相对而言,粪便隐血试验简单、易行、无创、节省人力物力,适合大规模人群筛查。我国部分学者已经开始重视大肠癌筛查,而粪便隐血试验在这些筛查中已被广泛应用。

Colorectal cancer is one of the most common malignant tumors of the digestive system. The incidence of colorectal cancer in China is increasing year by year. Screening for adenomas, precancerous lesions and early cancers can effectively reduce the incidence and mortality of colorectal cancer. Therefore, colorectal cancer screening is particularly important. At present, the colorectal cancer examination is mainly divided into fecal examination and colon structural examination. The fecal examination includes fecal occult blood test, fecal exfoliated cell test and fecal genetic analysis. The colon structural examination includes barium enema, colonoscopy and computed tomography colonography. Colonoscopy is considered as the gold standard for the diagnosis of colorectal cancer. It has the advantage of high accuracy, and can be used to find precancerous lesions and remove them at the same time. However, the screening should be greatly restricted because of its invasive examination, the need for intestinal preparation, obvious discomfort and the high cost of medical treatment. Comparatively, fecal occult blood test is simple, easy, non-invasive, saving manpower and material resources, and is suitable for large population screening. Some scholars in China have begun to pay attention to colorectal cancer screening, and fecal occult blood test is widely used in these screenings.