结直肠癌机会性筛查在粪便隐血阳性住院患者中的临床应用价值

Clinical Application Value of Opportunistic Screening for Colorectal Cancer in Hospitalized Patients with Positive Stool Occult Blood Test

【目的】探讨结直肠癌机会性筛查在粪便隐血阳性住院患者中的临床应用价值。【方法】回顾性分析2021年7月至2022年7月在浙江大学医学院附属第四医院接受结直肠癌机会性筛查的534例粪便隐血试验阳性的住院患者的临床资料,根据结直肠癌高危人群分类标准将患者分为高危人群组(n=99)和一般人群组(n=435)。分析粪便隐血试验及结肠镜检查情况,比较不同人群结肠镜检查结果。【结果】534例住院患者入院常规进行粪便隐血试验检测,结果均为阳性,其中接受结肠镜检查的有278例,依从率为52.1%(278/534)。结肠镜检出结直肠癌及癌前病变共106例,检出率为38.1%(106/278)。高危人群组进行肠镜检查的依从性为80.8%(80/99),显著高于一般人群组的45.5%,差异有统计学意义(χ^(2)=40.244,P<0.01)。高危人群组肠镜结果阳性率显著高于一般人群组,差异有统计学意义(χ^(2)=8.196,P=0.04)。【结论】粪便隐血阳性住院患者接受肠镜筛查依从性高,结直肠癌高危人群的依从性明显高于一般人群,医师的推荐是影响筛查依从性的重要因素,住院病人常规开展结直肠癌机会性筛查是一种适合中国国情的筛查模式之一。

【Objective】To explore the clinical application value of opportunistic screening for colorectal cancer in hospitalized patients with positive stool occult blood test.【Methods】A retrospective analysis was conducted on the clinical data of 534 hospitalized patients with positive stool occult blood test who underwent opportunistic screening for colorectal cancer at the Fourth Affiliated Hospital of Zhejiang University School of Medicine from July 2021 to July 2022.According to the classification criteria for high-risk populations of colorectal cancer,patients were divided into high-risk group(n=99)and general population group(n=435).The stool occult blood test and colonoscopy were analyzed,and the colonoscopy results were compared among different groups.【Results】534 hospitalized patients underwent routine stool occult blood test,all of which were positive.Among them,278 patients underwent colonoscopy,with a compliance rate of 52.1%(278/534).A total of 106 cases of colorectal cancer and precancerous lesions were detected by colonoscopy,with a detection rate of 38.1%(106/278).The compliance rate of colonoscopy in high-risk population group was 80.8%(80/99),which was significantly higher than that in general population group(45.5%),with significant difference(χ^(2)=40.244,P<0.01).The positive rate of colonoscopy in high-risk population group was significantly higher than that in general population,with significant difference(χ^(2)=8.196,P=0.04).【Conclusion】Hospitalized patients with positive stool occult blood test have high compliance with colonoscopy screening.The compliance rate of high-risk population of colorectal cancer is significantly higher than that of general population.The recommendation of doctors is an important factor affecting screening compliance.Routine screening for colorectal cancer opportunity in hospitalized patients is one of the screening models suitable for China's national conditions.