伺机性筛查新模式在结直肠肿瘤患者一级亲属中的探索性研究

An exploratory study of a new mode of opportunistic screening in first-degree relatives of patients with colorectal neoplasms

目的探究结直肠病房筛查新模式在结直肠肿瘤患者一级亲属筛查的有效性。方法采用结直肠肿瘤风险问卷评分、粪便潜血免疫化学检测(FIT)以及粪便多靶点FIT-DNA检测对2019年10月至2021年7月在中国医学科学院肿瘤医院结直肠外科就诊的结直肠癌及进展期腺瘤患者的一级亲属进行检测,根据检测结果将一级亲属进行筛查风险分层以及肠镜检查推荐分类,分析不同分层分类后一级亲属的肠镜依从率与病变检出率。结果共250名受试者被纳入本研究。总体人群肠镜依从率为38.0%(95/250),肠镜病变检出率为9.5%(9/95);高风险人群(A类推荐人群)肠镜依从率为78.9%(15/19),肠镜病变检出率为26.7%(4/15);中风险人群(B类推荐人群)肠镜依从率为61.2%(30/49),肠镜病变检出率为16.7%(5/30);低风险人群(C类推荐人群)肠镜依从率为27.5%(50/182),肠镜病变检出率为0(0/50)。结论三种筛查方法联合使用可以高效精准地区分一级亲属的筛查风险,此方案是一个可以在病房开展的有效可行的结直肠肿瘤患者一级亲属人群的伺机性筛查新模式。

Objective To explore the effectiveness of a new mode of screening in colorectal ward in first-degree relatives of patients with colorectal neoplasms.Methods Colorectal cancer risk questionnaire,fecal immunochemical test(FIT)and multitarget stool DNA testing were used to detect first-degree relatives of colorectal cancer and advanced adenoma patients treated at the Department of Colorectal Surgery,Cancer Hospital,Chinese Academy of Medical Sciences from October 2019 to July 2021.Based on the test results,screening risk stratification for first-degree relatives and recommended colonoscopy classification were performed,and their colonoscopy compliance rate and lesion detection rate were analyzed.Results A total of 250 subjects were included in this study.The colonoscopy compliance rate of the overall population was 38.0%(95/250),and the detection rate of colonoscopy lesions was 9.5%(9/95);the colonoscopy compliance rate of category A recommended population was 78.9%(15/19),the lesion detection rate was 26.7%(4/15);the colonoscopy compliance rate of category B recommended population was 61.2%(30/49),and the lesion detection rate was 16.7%(5/30);the colonoscopy compliance rate of the category C recommended population was 27.5%(50/182),and the lesion detection rate was 0(0/50).Conclusion The combined use of the three screening methods can efficiently and accurately distinguish the screening risk of first-degree relatives.This program is an effective and feasible ward-based mode of opportunistic screening in first-degree relatives of patients with colorectal neoplasms.