无症状结肠镜筛查人群中腺瘤检出率影响因素分析

Analysis of influencing factors of adenoma detection rate in asymptomatic colonoscopy screening population

目的:探讨影响无症状结肠镜筛查人群中腺瘤检出率的相关因素。方法:选取2020年10月—2021年10月期间来我院行结肠镜筛查的无症状人群作为研究对象,按受检者性别、年龄、烟龄等17个因素的不同分别计算腺瘤检出率,比较分析腺瘤检出率和可能的影响因素之间的关系。结果:共366例患者纳入该研究,检出腺瘤66例(18.0%)。在影响腺瘤检出率因素的比较中,烟龄≥10年者高于从不吸烟;饮酒者高于不饮酒;高中、中专及以上学历者高于初中和文盲、小学学历者;退镜时间≥6min者高于<6min者;亚太结直肠筛查评分(APCS)风险分层高风险组者高于中风险组者(P<0.05)。多因素分析结果显示,饮酒者和退镜时间≥6 min者(P<0.05)的腺瘤检出率较高。结论:结肠镜筛查无症状人群中烟龄≥10年、饮酒、APCS风险分层高风险及高中、中专及以上学历者有相对较高的腺瘤检出率,退镜时间≥6min同样可提高检出率。

Objective:To investigate the factors associated with adenoma detection rate in the asymptomatic colonoscopy screening population.Methods:Asymptomatic people who came to our hospital for colonoscopy screening from October 2020 to October 2021 were selected as the study subjects,and the adenoma detection rate was calculated according to the difference of 17 factors,such as gender,age,and smoking age of the examinees,respectively,and the relationship between the adenoma detection rate and the possible influencing factors was comparatively analyzed.Results:Three hundred and sixty-six patients were included in the study,and 66 adenomas(18.0%)were detected.In the comparison of factors affecting adenoma detection rate,those who had smoked for≥10 years were higher than those who had never smoked;those who consumed alcohol were higher than those who did not;those who had high school,middle school and above education were higher than those who had junior high school and illiterate,elementary school education;those who had a withdrawal colonoscopy time≥6 min were higher than those who had a withdrawal colonoscopy time of<6 min;and those who were in the Asia-Pacific colorectal screening score(APCS)risk-stratified high-risk group were higher than those who were in the intermediate-risk group(P<0.05).The results of the multifactorial analysis showed that the adenoma detection rate was higher in those who consumed alcohol and those who were withdrawn from the colonoscopy for≥6 min(P<0.05).Conclusion:Among the asymptomatic population with colonoscopic screening,those with≥10 years of smoking age,alcohol consumption,high risk of APCS risk stratification and higher education level have relatively higher adenoma detection rates,and the withdrawal colonoscopy time≥6 min can also increase the detection rate.