较高的状息肉检测率与结直肠镜后结直肠癌的风险较低有关:来自新罕布什尔州结直肠镜注册表的数据
Joseph C Anderson1,2,3,4, Douglas K Rex5, Todd A Mackenzie1
1Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
The American journal of gastroenterology
|July 7, 2023
概括
在结肠镜检查中,状状病变 (SSLDR) 的较高检测率与结肠镜后结肠直肠癌 (PCCRC) 的风险降低有关. 这项研究验证了SSLDR作为结肠镜检查的关键质量指标.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 结肠镜后结肠直肠癌 (PCCRC) 尽管在内镜检测方面取得了进展,但仍然是一个令人担忧的问题.
- 在结肠镜检查过程中,常常会忽略状状病变 (SSL),并且与间隔癌症有关.
- 为了提高结肠镜检查的有效性,需要标准化的质量指标.
研究的目的:
- 调查形形病变检测率 (SSLDR) 与PCCRC的发生率之间的关联.
- 为了确定SSLDR是否可以作为结肠镜性能的有效质量指标.
主要方法:
- 利用了来自新罕布什尔州结肠镜注册和NH州癌症注册的数据.
- 包括被诊断患有结肠直肠癌 (CRC) 或接受结肠镜检查的患者.
- 定义PCCRC是指在索引结肠镜检查后至少6个月诊断出CRC.
主要成果:
- 分析了26,901名患者,其中162人被诊断患有PCCRC.
- 在最高SSLDR五分位数 (≥6%) 的内镜师中发现PCCRC的危险比率最低,危险比率为0.29 (95%CI 0.16-0.50).
结论:
- 获得更高SSLDR的内镜医生在他们的患者中显示PCCRC的风险明显降低.
- 这些发现支持SSLDR作为临床相关和可操作的结肠镜质量测量方法的验证.
- 提高SSL检测速率可能会减少PCCRC的负担.
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