在威尔士优化紧急怀疑结肠癌转诊和减少结肠镜等待时间
Atreya Subramanian1, Ashwin Nair1, Parinita Swarnkar1
1General Surgery, Aneurin Bevan University Health Board, Newport, GBR.
Cureus
|December 31, 2024
概括
最近的结肠镜和CT扫描可以帮助降低紧急怀疑癌症的转诊率. 阴性结肠镜和CT扫描,无论FIT结果如何,可以安全地减少对结肠直肠癌查的不必要转诊.
科学领域:
- 胃肠病学 胃肠病学
- 诊断成像 诊断成像 诊断成像
- 在瘤学瘤学.
背景情况:
- 对于结直肠癌 (CRC) 的紧急疑似癌症 (USC) 转诊对医疗保健资源造成了重大负担.
- 准确的风险分层对于优化患者途径和管理等待列表至关重要.
研究的目的:
- 评估最近的结肠镜检查和CT扫描以及便免疫化学测试 (FIT) 在潜在降级USC转诊的有用性.
- 识别能够准确预测阴性结肠镜检查结果的诊断测试组合.
主要方法:
- 一项回顾性单中心研究分析了2022年USC500例结肠镜转诊的情况.
- 研究人员审查了在转诊前两年内CT扫描和结肠镜检查的结果.
- 便免疫化学测试 (FIT) 结果与成像和内镜检测结果相关.
主要成果:
- 在500个USC转诊中,有160个呈CRC阳性.
- 之前的阴性结肠镜和CT扫描组合,无论FIT结果如何,正确识别了没有癌症的病例.
- 可能有8% (40例转诊) 根据组合的阴性测试结果可以安全地降级.
结论:
- 之前的阴性结肠镜检查和CT扫描强烈表明结肠直肠USC转诊的降级,即使FIT结果是未知的或阳性的.
- 阴性CT扫描与阴性FIT,或在两年内进行正常结肠镜检查,支持安全降级.
- 这种方法可以提高等待时间,降低USC途径内的成本,尽管需要更大的验证研究.
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