社区大肠癌高危者肠镜检查结果分析

Analysis of the results of of colonoscopy in high-risk patients with colorectal cancer in the community

目的:分析上海同济大学附属杨浦医院社区大肠癌筛查高危者肠镜检出结果。方法:2017年5月至2020年12月对社区629名50岁以上大肠癌筛查高危者进行结肠镜检查,并对检查结果进行分析。高危者中女性339人,男性290人。结果:在高危者中,单独粪便潜血试验阳性者213人,单独危险度评估阳性者328人,二者均阳性者88人。在结肠镜检查中共发现增生性息肉53人(男20,女33),腺瘤性息肉209人(男120,女89),进展期腺瘤20人(男8,女12);肠癌14人(男9,女5);其中男性参与率低于女性,尤其是低年龄组参与率更低(P<0.05),且男性腺瘤性息肉检出高于女性(P<0.05);单独粪便潜血试验阳性者的肠癌检出率高于单独危险度评估阳性者(P<0.05),两者阳性者肠癌检出率最高(P<0.05)。结论:社区居民的大肠癌筛查有利于早发现癌前病变及大肠癌,值得进一步在社区中推荐。

Objective:To analyze the results of colonoscopy in high-risk patients with colorectal cancer in the community of Yangpu Hospital Affiliated to Tongji University,Shanghai.Methods:From May 2017 to December 2020,colonoscopy was performed on 629 high-risk colorectal cancer screening patients over 50 years old in the community,and the results of examination were analyzed.There were 339 women and 290 men in the high-risk group.Results:In the high-risk group,there were 213 persons with positive fecal occult blood test alone,328 persons were assessed as positive for individual risk,and 88 of them were both positive;a total of 53 patients(20 males and 33 females)with proliferative polyps were found during colonoscopy,209 with adenomatous polyps(120 males,and 89 females),20 with advanced adenomas(8 males,and 12 females),and 14 with colon cancers(9 males,and 5 females);the participation rate of the male was lower than that of the female,especially that in the low age group was even more lower(P<0.05),and the detection rate of adenomatous polyps in the males was higher than that in the females(P<0.05);the detection rate of colon cancer in patients with positive fecal occult blood test alone was higher than that in patients with positive risk assessment alone(P<0.05),and the positive rate of both was the highest(P<0.05).Conclusion:The colorectal cancer screening for the community residents is conducive to early detecting the precancerous lesions and colorectal cancer,which is worth of further recommendation in the community.