摘要
目的：提出易导致腺瘤复发或癌变的高危特征和因素，延长非高危人群的结肠镜随访间期，从而降低医疗费用。方法：行结肠镜下腺瘤摘除术患者５０４例，随访间期６～４８个月，分析年龄、性别、腺瘤数量、最大直径和病理类型等因素与腺瘤复发的关系。结肠镜复查时发现以下病变者归人高危人群：绒毛管状腺瘤、绒毛状腺瘤、重度不典型增生／原位癌、浸润性癌或腺瘤直径≥ １ｃｍ及复发腺瘤数≥ ４枚。结果：经相关分析，腺瘤复发与原腺瘤数量和大小的增加呈正相关（Ｐ＜０．００１），与年龄、性别、原腺瘤病理类型及结肠镜随访间期等因素无关。结论：可延长低危人群（首次结肠镜检查仅发现１或２枚腺瘤且直径均＜１ｃｍ者）的结肠镜随访间期，从而大大降低结肠癌监控的费用。
Background/Aims: The cost of colonoscopic surveillance is directly related to the frequency of examinations, and follow-up study should ideally be reserved for patients with a clearly increased risk of developing colorectal cancer. Methods: 504 patients who had their colonic adenomas removed at colonoscopy and taken a surveillance examination within 6 to 48 months, were evaluated. Potential risk factors studied were age, gender, number, size and pathologic pattern. The characteristics of the following lesions were considered high risks for cancer development with poor prognosis: tubulovillous or villous adenoma, high-grade dysplasia/carcinoma in situ, invasive cancer, size ≥ 1 cm, and 4 or more adenomas. Results: Regression analysis showed only increased number and size of adenoma was positively correlated with its recurrence (P<0.001), while age, gender, pathologic pattern of the adenoma and the time interval between eolonoscopies were not relevant. Conclusions: Patients with 1 or 2 adenomas less than 1 cm in diameter on first colonoscopic examination are considered as low-risk group and the surveillance interval can be prolonged so as to lower the expenses used in colonoscopy.
出处
《胃肠病学》
2001年第1期35-37,共3页
Chinese Journal of Gastroenterology
关键词
结肠肿瘤
腺癌
结肠镜检查
随访研究
Colonic Neoplasms
Adenoma
Colonoscopy
Follow-Up Studies
