计算机断层扫描 在便中的结肠镜 免疫化学测试 在结肠直肠癌查计划中呈阳性
Sarah Moen1, Fleur E Marijnissen1, Jochim S Terhaar Sive Droste2
1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
概括
与结肠镜检查相比,在便免疫化学测试 (FIT) 阳性的计算机断层扫描结肠镜检查 (CTC) 显示,晚期瘤检测率较低,CT间隔后结肠直肠癌 (CRC) 的风险更高. 质量问题和并发症需要在CRC查中为CTC制定结构化的质量保证计划.
科学领域:
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 荷兰结直肠癌 (CRC) 查计划使用便免疫化学测试 (FIT).
- 患有并发症或拒绝结肠镜检查的FIT阳性患者可以接受计算机断层扫描结肠镜检查 (CTC).
- 有限的数据存在于CTC表现和FIT阳性的程序后CRC风险.
研究的目的:
- 为了评估CTC在FIT正的收益率.
- 评估临床管理和CT后间隔CRC (PCT-CRC) 的风险.
- 为了确定与CTC相关的潜在质量和安全问题,在这个人群中.
主要方法:
- 一项队列研究分析了2014-2019年期间在荷兰CRC查计划中接受CTC的FIT阳性患者的数据.
- 与国家癌症注册局的数据链接,以识别PCT-CRC.
- 评估CTC收益率,管理决策以及PCT-CRC利率.
主要成果:
- 在接受CTC的2794名FIT阳性患者中,5.7%患有CRC,19.8%患有≥10毫米的息肉.
- 在21.1%的患者中检测到高级瘤,其中4.0%的确诊CRC.
- 在49个月的中位随访期间发生了16次PCT-CRC (0.6%);报告了5次并发症 (0.2%),而且质量报告往往缺乏.
结论:
- 在FIT阳性患者中,CTC显示了较低的晚期瘤检测率和较高的PCT-CRC率,高于从结肠镜数据中预期的.
- 很大一部分并发症和缺乏质量报告突出了需要改进的领域.
- 一个结构化的质量保证计划和对CTC患者选择的批判性评估至关重要.
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