结直肠癌与结肠镜检查腺瘤检出率的关系

F. Mendoza-Moreno, E. Ovejero-Merino, J. Ocaña, Fernando Noguerales-Fraguas, Belén Matías-García, Ana Quiroga-Valcárcel, Alma Blázquez-Martín, A. Minaya‐Bravo, A. Silva-Mato, Á. Gutiérrez
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摘要

背景:近年来,结直肠癌发病率急剧下降。基于内窥镜下脊髓样癌前病变切除的筛查项目是实现理想改善的基础。材料与方法:对2007年1月至2012年12月行内镜下结肠息肉切除术的患者进行前瞻性观察研究。我们分析了结肠镜检查的“息肉率”、患者数量、随访时间以及“与后期癌症表现的关系”。结果:841例患者(女性357例,占42.4%,男性484例,占57.65%)共发生7007例结直肠息肉,中期随访66 +/- 21.84个月。在随访期间,12例结直肠癌患者在“每次结肠镜息肉率”、“晚期腺瘤数”(Z=0′11,p=0′91)和“总腺瘤性息肉数”(Z=1′84,p=0′07)方面均无统计学差异。然而,我们可以看到,非结直肠癌患者晚期腺瘤的“每次结肠镜息肉率”(Z=4′61,p <0′001)和原始息肉数(Z=7′09,p <0′001)较低。结论:通过比较患者人数、结肠镜检查次数和随访时间,发现晚期结直肠癌患者的晚期腺瘤发生率较高。
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Relationship Between Colorectal Carcinoma and Adenoma Detection Rate by Colonoscopy
Background: in recent years, colorectal cancer incidence has declined dramatically. Screening programs, based on endoscopic resection of polipoid precancerous lesions, are being fundamental in that desirable improvement. Material and methods: prospective observational study of a set of patients who had an endoscopic resection of colonic polipoid lesions from January-2007 to December-2012. We analized “polyps rate” by colonoscopy, number of patients, follow-up time, and “relationship with later cancer appearance“. Results: 841 patients (357 women, a 42’4%, and 484 men, a 57’65%) with a total of 7007 colorectal polyps and a medium follow-up of 66 +/- 21’84 months. During the following 12 patients were diagnosed of colorectal cancer, who had not had any statistical significant difference in “polyps rate per colonoscopy”, nor for the number of “advanced adenomas” (Z=0’11, p=0’91), nor for “total adenomatous polyps” (Z=1’84, p=0’07). Nevertheless, we could see that patients without colorectal cancer showed lower “polyps rate per colonoscopy” of advanced adenoma (Z=4’61, p <0’001) and raw number of polyps (Z=7’09, p <0’001). Conclusions: when comparing rates by number of patients, number of colonoscopic explorations and follow-up time, the advanced adenoma rate was found to be higher in patients who later developed colorectal carcinoma.
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