象山地区相对无症状体检人群电子直乙结肠镜息肉检出率及其与饮食习惯、血清肿瘤标志物的关系

Detection Rate of Electronic Sigmoidoscopy Polyps in Relatively Asymptomatic People in Xiangshan Area and Its Relationship with Eating Habits and Blood Tumor Markers

目的分析象山地区相对无症状体检人群电子直乙结肠镜检查结果,统计息肉样病变分布情况,探讨其与饮食习惯的相关性,为早期筛查与预防肛肠疾病提供参考。方法选取2018年1月~2019年3月在我院体检中心接受电子直乙结肠镜检查的1043例相对无症状体检人群,分析检查结果及疾病分布情况,按照不同饮食习惯进行分组,比较各组息肉样病变检出率,分析饮食习惯对息肉样病变的影响;检测各组肿瘤标志物CEA、CA199、CA724,分析肿瘤标志物在癌前疾病的表达意义。结果①1043例相对无症状体检人群中共检出结直肠息肉222例(21.28%),其中男性检出率高于女性,差异有统计学意义(P<0.05);②51~60岁人群直肠息肉检出率高于≤40岁及41~50岁人群,差异有统计学意义(P<0.05);Logistic回归分析显示,每天定量饮水结直肠息肉发病风险是口干才饮水的0.587倍(OR=0.587,P<0.05);基本不进食水果发生结直肠息肉的风险是每天摄入水果的8.408倍(OR=8.408,P<0.05);基本不进食辛辣食物发生结直肠息肉的风险是每天进食辛辣食物的0.369倍(OR=0.369,P<0.05),偶尔进食辛辣食物发生结直肠息肉的风险是每天进食辛辣食物的0.570倍(OR=0.570,P<0.05);偶尔进食海产品及海鲜发生结直肠息肉的风险是经常进食海产品及海鲜的0.509倍(OR=0.509,P<0.05),基本不进食海产品及海鲜发生结直肠息肉的风险是经常进食海产品及海鲜的0.329倍(OR=0.329,P<0.05)。③不同癌前病变患者的血清肿瘤标志物CEA、CA199、CA724水平比较,差异无统计学意义(P>0.05)。结论电子直乙结肠镜有助于筛查结直肠疾病,可纳入体检项目,多饮水、多吃水果,降低辛辣食物及海产品的摄入对预防结直肠息肉发生有重要作用。

Objective To analyze the results of electronic sigmoidoscopy in a relatively asymptomatic population in Xiangshan area,to calculate the distribution of polypoid lesions,and to explore its correlation with eating habits,so as to provide references for early screening and prevention of anorectal diseases.Methods A total of 1043 relatively asymptomatic people who underwent electronic sigmoidoscopy in our hospital's physical examination center from January 2018 to March 2019 were selected.The examination results and disease distribution were analyzed.The groups were grouped according to different dietary habits,and the groups were compared.The detection rate of polypoid lesions,analysis of the influence of dietary habits on polypoid lesions;detection of tumor markers CEA,CA199,CA724 in each group,and analysis of the significance of tumor markers in precancerous diseases.Results①A total of 222 cases(21.28%)of colorectal polyps were detected in 1043 cases of relatively asymptomatic physical examination population,among which the detection rate of males was higher than that of females,the difference was statistically significant(P<0.05);②The detection rate of rectal polyps in people aged 51-60 higher than 40 years old and 41-50 years old population,the difference was statistically significant(P<0.05);Logistic regression analysis showed that the risk of colorectal polyps in drinking water daily was 0.587 times that of drinking water with dry mouth(OR=0.587,P<0.05);the risk of colorectal polyps caused by not eating fruit was 8.408 times that of daily fruit intake(OR=8.408,P<0.05);the risk of colorectal polyps caused by not eating spicy food was 0.369 of eating spicy food every day(OR=0.369,P<0.05),the risk of colorectal polyps from eating spicy food occasionally was 0.570 times that of eating spicy food every day(OR=0.570,P<0.05);The risk of colorectal polyps in occasional consumption of seafood was 0.509 times that of regular consumption of seafood and seafood(OR=0.509,P<0.05),The risk of colorectal polyps from not eating seafood and seafood was 0.329 times that of eating seafood and seafood(OR=0.329,P<0.05).③There was no significant difference in serum tumor markers CEA,CA199,CA724 levels in patients with different precancerous lesions(P>0.05).Conclusion Electronic sigmoidoscopy was helpful for the screening of colorectal diseases.It could be included in the physical examination items.Drinking more water,eating more fruits,and reducing the intake of spicy foods and seafood played an important role in preventing colorectal polyps.