单中心就诊中老年人群结肠癌结肠镜筛查结果研究

Colonoscopy screening results in middle-aged and old people in single center

目的探讨于该院就诊的中老年人群结肠癌结肠镜筛查结果。方法研究对象为2015年1月-2017年12月在该院进行结肠癌筛查的40～74岁人群共96 352例,通过危险度评估与粪便免疫法粪便潜血试验进行结肠癌初步筛查,将初步筛查为高危人群的对象判定为初筛阳性,进行结肠镜进行精筛确诊,对有病变者取组织活检,组织活检结果作为判定金标准,分析筛查结果。结果 96 352例参与筛查的人群中,初步筛查阳性者5 078例,占5.3%;96 352例参与初筛的人群中,男47 153例(48.9%),女49 199例(51.1%),而1 212例肠镜检查的人群中,男668例,女544例,接受肠镜检查的男性与女性比较,差异无统计学意义(22.6%vs 25.7%,P>0.05),其中40～49岁占15.0%,50～59岁占28.9%,60～69岁占40.8%,70～74岁占15.3%。5 078例初步筛查阳性者中,1 212例接受结肠镜检查,结肠镜顺应率23.9%。结肠镜筛查中,男性结肠息肉、结肠炎和结肠癌的发生率明显高于女性,差异均有统计学意义(P <0.05),结肠镜筛查中,不同年龄组结肠息肉、结肠炎和结肠癌的发生率比较,差异均有统计学意义(P <0.05),结肠息肉和结肠癌的发生率随着年龄的升高呈上升趋势,而结肠炎的发生率则呈下降的趋势。1 212例行结肠镜检查的人群中,共检出结肠癌30例,占2.5%,其中早期结肠癌14例(46.7%),中晚期结肠癌16例(53.3%);早期结肠癌中,男9例(64.3%),女5例(35.7%),不同性别之间差异无统计学意义(P>0.05)。结论该院就诊中老年人群结肠镜筛查结果显示,男性结肠息肉、结肠炎、结肠癌的发生率明显高于女性,结肠息肉和结肠癌的发生率随着年龄的升高呈上升趋势。

Objective To analyze the results of colonoscopy screening for colon cancer in middle aged and elderly people in a single center. Methods From January 2015 to December 2017, 96 352 patients aged 40 ~ 74 years were selected for colon cancer screening. The primary screening of colon cancer was carried out by means of risk assessment and two fecal immune fecal occult blood tests. The object of primary screening for high risk population was identified as positive screening, the colonoscopy was performed for fine screening diagnosis, biopsy was taken for the patients with pathological changes, and the results of tissue biopsy were used as the gold standard to analyze the results of screening. Results Among the 96 352 people who took part in the screening, 5078 were positive for primary screening, accounting for 5.3%, 47 153 were males and 49 199 were females, while 668 were males and 544 were females in 1 212 cases of colonoscopy. The rate of colonoscopy had no difference in male than female(22.6%vs 25.7%, P > 0.05), in which 40~49 years old(15.0%), 50 ~ 59 years old(28.9%), 60 ~ 69 years old(40.8%), 70 ~ 74 years old(15.3%). 1 212 cases did colonoscopy examination in 5078 cases, colonoscopy compliance rate(23.9%).The incidence of colonic polyps, colitis and colon cancer in the positive screening population was significantly higher than that in the female(P < 0.05). The incidence of colonic polyps, colitis and colonic cancer in different age groups were significantly different among the positive screening population(P < 0.05). The incidence of colonic polyps and colon cancer increased with the increase of age, and the incidence of colitis decreased. There were 30 cases(2.5%)of colon cancer in 1 212 patients who took part in colonoscopy, including 14 cases(46.7%) in the early stage and 16 cases(53.3%) in the middle and late stage. There were 9 cases(42.9%) in males and 5 cases(55.6%) in females. There was no significant difference between male and female(P > 0.05). Conclusion The colonoscopy screening results of middle and old people in our hospital showed that the incidence of colonic polyps, colitis and colon cancer in males was significantly higher than that in females. The incidence of colonic polyps and colon cancer increase with age.