石河子地区近十年结肠镜成人结直肠癌及腺瘤检出情况的横断面调查

A cross-sectional investigation on the detection of colorectal cancer and adenoma in adults under colonoscopy in Shihezi in recent ten years

目的调查石河子地区近十年结肠镜下成人结直肠癌(colorectal cancer,CRC)、结直肠腺瘤和进展期腺瘤检出率的变化趋势。方法2010年1月1日—2019年12月31日期间,就诊于石河子大学医学院第一附属医院完成结肠镜检查的病例纳入调查,通过查阅电子病历系统收集病历资料,具体信息包括患者年龄、性别及结直肠腺瘤或CRC的部位、数量、大小和病理类型等。主要观察结直肠腺瘤、结直肠进展期腺瘤和CRC的检出率,包括10年总体检出率以及前五年(2010—2014年)总体检出率和后五年(2015—2019年)总体检出率。结果共纳入50645例,经排除标准排除14931例,最终共35714例纳入数据分析。结直肠腺瘤、结直肠进展期腺瘤和CRC的10年总体检出率分别为17.65%(6302/35714)、4.45%(1589/35714)和3.71%(1324/35714)。结直肠腺瘤后五年总体检出率[20.33%(4565/22457)]高于前五年[13.10%(1737/13257)];结直肠进展期腺瘤后五年总体检出率[4.69%(1053/22457)]高于前五年[4.04%(536/13257)];CRC后五年总体检出率[3.30%(741/22457)]低于前五年[4.40%(583/13257)]。结论石河子地区2015—2019年结直肠腺瘤检出率较2010—2014年有较大幅度升高,结直肠进展期腺瘤检出率较2010—2014年有小幅升高,而CRC检出率较2010—2014年有小幅下降,由此推测结肠镜检查发现并切除结直肠腺瘤对降低CRC发病率可能具有重要作用。

Objective To investigate the change of the detection rate of colorectal cancer(CRC),colorectal adenoma and advanced adenoma in adults under colonoscopy in Shihezi in the past ten years.Methods Data of patients who completed colonoscopy in the First Affiliated Hospital of Shihezi University School of Medicine from January 1,2010 to December 31,2019 were investigated.The medical records were collected by consulting the electronic medical record system,including the age and sex of patients and the location,quantity,size and pathological type of lesions.The detection rates,including the overall detection rate in the past 10 years,those in the first 5 years(from 2010 to 2014)and the second 5 years(from 2015 to 2019)of colorectal adenomas,advanced colorectal adenomas and CRC,were studied.Results A total of 50645 cases were included,14931 cases were excluded by the exclusion criteria,and finally a total of 35714 cases were included in the data analysis.The 10-year overall detection rates of colorectal adenoma,advanced colorectal adenoma and CRC were 17.65%(6302/35714),4.45%(1589/35714)and 3.71%(1324/35714),respectively.The overall detection rates of colorectal adenoma and advanced colorectal adenoma in the second 5 years were higher respectively than those in the first 5 years[20.33%(4565/22457)VS 13.10%(1737/13257),4.69%(1053/22457)VS 4.04%(536/13257)].The overall detection rate of CRC in the second 5 years[3.30%(741/22457)]was lower than that in the first 5 years[4.40%(583/13257)].Conclusion Compared with 2010 to 2014,the detection rate of colorectal adenoma in Shihezi area in 2015 to 2019 increased significantly,the detection rate of advanced colorectal adenoma increased slightly,and the detection rate of CRC decreased slightly.Therefore,the detection and resection of colorectal adenoma by colonoscopy may be important in reducing the incidence of CRC.