伺机性筛查新模式在结直肠肿瘤患者配偶的探索性研究

An exploratory study of a new mode of opportunistic screening in spouses 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配偶筛查的有效性。方法采用结直肠肿瘤风险问卷调查、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配偶进行检测,根据检测结果将配偶的筛查风险以及肠镜检查推荐分为A、B、C、D四类,分析不同分类后配偶肠镜依从率与病变检出率。结果共206名受试者被纳入本研究。总体配偶人群肠镜依从率为29.6%(61/206),肠镜病变检出率为9.8%(6/61);A类至D类推荐人群肠镜依从率分别为90.9%(10/11)、53.5%(23/43)、20.5%(23/112)和12.5%(5/40),肠镜病变检出率分别为30.0%(3/10)、8.7%(2/23)、4.3%(1/23)和0(0/5)。结论三种筛查方法联合使用可以高效精准地区分配偶的筛查风险,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配偶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 spouses of patients with colorectal neoplasms.Methods Colorectal cancer risk questionnaire,fecal occult blood test and multitarget stool FIT-DNA testing were used to detect spouses 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,the spouses'screening risks and colonoscopy recommendations were divided into four categories:A,B,C,and D,and the spouses'colonoscopy compliance rate and lesion detection rate were analyzed.Results A total of 206 subjects were included in this study.The colonoscopy compliance rate of the overall population was 29.6%(61/206),and the lesion detection rate was 9.8%(6/61).The colonoscopy compliance rates of the recommended groups from category A to category D were 90.9%(10/11),53.5%(23/43),20.5%(23/112)and 12.5%(5/40),respectively.The lesion detection rates were 30.0%(3/10),8.7%(2/23),4.3%(1/23)and 0(0/5),respectively.Conclusion The combined use of the three screening methods can efficiently and accurately distinguish the screening risk of spouses.This program is an effective and feasible ward-based mode of opportunistic screening in spouses of patients with colorectal neoplasms.