1470例体检人群内镜检出特征分析

Analysis of the characteristics of endoscopy in 1470 physical examination

目的:探讨体检人群内镜检查临床特征及病理变化,以期为消化道早癌防治提供指导策略。方法:以2019年1月至2020年7月期间行内镜检查的1470例体检人群为研究对象,年龄为23-95岁,平均年龄(49.76±9.74)岁,共分为5个年龄组,活检标本1070例,均进行病理检查。结果:体检人群以41-50岁年龄组人群最多,占比38.23%,其次为51-60岁年龄组,占比33.20%。镜下表现以非萎缩性胃炎占比最高,为41.84%,其次为息肉,占比29.93%,粘膜下肿瘤及恶性肿瘤占比1.36%。病理检查显示:萎缩性胃炎检出率为15.58%,其中中度肠化生和重度肠化生分别占受检人群总数的5.51%和0.34%;息肉占检查人群的29.93%,以增生性肠息肉占比最高,为15.10%;腺瘤检出率为9.86%,以管状腺瘤占比最高,为6.73%。恶性肿瘤4例,占比0.27%,全部为结肠腺癌。51-60岁年龄组与>61岁年龄组萎缩性胃炎与其它年龄组均有显著性差异(P<0.05),且萎缩性胃炎检出率男性比女性高(P>0.05)。51-60岁年龄组息肉检出率明显高于其它年龄组(P<0.05),性别与息肉发生率无显著性差异(P>0.05)。结论:年龄超过50岁的人群萎缩性胃炎与肠息肉发生率显著增高,且随着年龄的增长一直处于高位,萎缩性胃炎男性发病率较女性高。消化内镜筛查可以及时发现萎缩性胃炎和息肉等慢性疾病,对中老年人群早癌的筛查与预防有指导意义。

Objective:To explore the clinical features and pathological changes of endoscopy in physical examination population and provide guidance for clinical diagnosis and treatment. Methods:A total of 1470 subjects who underwent endoscopy between January 2019 and July 2020,aged 23-95 years with an average age of(49.76±9.74)years,were divided into 5 age groups. 1070 biopsy specimens from the 1470 subjects were examined by pathological examination.Results:The majority of people in the physical examination group were 41-50 years old,accounting for 38.23%,followed by 51-60 years old group,accounting for 33.20%. The highest proportion of endoscopic manifestations was non-atrophic gastritis(41.84%),followed by polyps(29.93%),and submucosal tumors and malignant tumors(1.36%). Pathological examination showed that the detection rate of atrophic gastritis in 1470 patients was 15.58%,of which moderate intestinal metaplasia and severe intestinal metaplasia accounted for 5.51% and 0.34% of the total number of patients,respectively.Pathological examination of polyps accounted for 29.93% of the total population,among which the proportion of hyperplastic intestinal polyps was the highest(15.10%). The detection rate of adenoma was 9.86%,and the proportion of tubular adenoma was the highest(6.73%). 4 cases(0.27%) were malignant tumors,all of which were colonic adenocarcinoma. There were significant differences in atrophic gastritis between 51-60 years old and >61 years old and other age groups(P<0.05),and the detection rate of atrophic gastritis in males was higher than that in females(P<0.05).The detection rate of polyps in 51-60 years old group was significantly higher than that in other age groups(P<0.05),but there was no significant difference between gender and polyp incidence(P>0.05). Conclusion:The incidence of atrophic gastritis and intestinal polyp increased significantly in the population over 50 years old,and remained high rate with the growth of age. The incidence of atrophic gastritis is higher in men than in women. Digestive endoscopy screening during physical examination can detect chronic diseases such as atrophic gastritis and polyp in time,which has guiding significance for screening and prevention of early cancer in middle-aged and elderly people.