LDCTC在筛查结直肠癌及癌前病变中的应用

Ap plication of LDCTC in Screening Colorectal Cancer and Precancerous Lesions

目的 探讨低剂量CT结肠成像(LDCTC)筛查结直肠癌及癌前病变的价值。方法 纳入筛查104例,问卷调查表参考中国结直肠癌早诊早治专家共识2020版,筛查流程参考中国结直肠癌早期筛查流程专家共识意见2019版。高危人群在肠道清洁准备后做LDCTC,完成后即刻行肠镜检查。结果 104例中80例完成问卷筛查,顺应性为76.9%,35例一般人群粪便隐血筛查后有4例高危人群,2例完成肠镜复筛,复筛顺应性为50%。47例高危人群中结直肠癌3例占6.4%,息肉9例占19.1%,其中腺瘤6例占12.8%。LDCTC筛查结直肠占位性病变的灵敏度是77%,特异度为94%,Kappa值为0.73。结论 在普通人群中76.9%的愿意接受结直肠癌的问卷筛查,一般人群中粪便隐血实验转高危人群占11.4%,而高危人群中发现结直肠癌的概率是6.4%,发现息肉病变的概率是19.1%,LDCTC和肠镜筛查结直肠癌的一致性较好,可以作为结直肠癌的有效筛查方式之一。

Objective To investigate the value of low dose CT colonography(LDCTC)in screening colorectal cancer and precancerous lesions.Method 104 cases were included in screening.The questionnaire was based on the Chinese expert consensus on early Diagnosis and Early treatment of colorectal cancer(2020 edition),and the screening process was based on the Expert consensus on early screening process of Colorectal cancer(2019 edition).LDCTC of the high-risk groups was performed after preparation for intestinal cleansing,and colonoscopy was performed immediately after LDCTC.Results Of the 104 cases,80 cases completed questionnaire screening,compliance was 76.9%,of the 35 cases in the general population,4 cases in the high-risk group after fecal occult blood screening,2 cases completed colonoscopy rescreening,compliance was 50%.Among 47 high-risk population,3 cases were colorectal cancer(6.4%),9 cases were polyp(19.1%),and 6 cases were adenoma(12.8%).The sensitivity,specificity and Kappa value of LDCTC for screening colorectal space-occupying lesions were 77%,94%and 0.73 respectively.Conclusion 76.9%of the general population were willing to accept the questionnaire screening for colorectal cancer,and 11.4%of the general population were transferred from fecal occult blood test to high-risk group,while the probability of colorectal cancer detection in high-risk group was 6.4%and the probability of polyp detection was 19.1%.There was a good consistency between LDCTC and colonoscopy screening for colorectal cancer.It can be used as one of the effective screening methods for colorectal cancer.