超越年龄和家族病史:症状作为结直肠癌查预测因素
Majd Khader1, Rimon Artoul2, Jorge-Shmuel Delgado1
1The Gastroenterology Institute, Assuta Medical Center, Tel Aviv, Israel.
概括
结肠直肠癌 (CRC) 查可以通过考虑血和便隐性血液检测等症状来改进. 这些因素在CRC查中显著增加了聚检测率 (PDR) 和腺瘤检测率 (ADR).
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:
- 目前的结肠直肠癌 (CRC) 查指南主要依赖于年龄和家族史.
- 临床相关的患者表现在优化CRC查性能方面未得到充分利用.
研究的目的:
- 调查CRC相关的临床表现和关键查绩效指标之间的相关性:聚检测率 (PDR) 和腺瘤检测率 (ADR).
主要方法:
- 在以色列八个医疗中心,从2016年至2022年间对235,781次结肠镜手术进行了横截面回顾分析.
- 数据包括患者人口统计学,临床病史 (血病,腹痛,CRC家族病史,便隐性血液,贫血),以及多/腺瘤/CRC分类.
主要成果:
- 出血的存在与较高的PDR (36.8%) 和ADR (12.1%) 相比,其缺乏 (28.7%,10.8%).
- 便隐性血液阳性显著增加PDR (48.3%) 和ADR (21.5%) 与负面结果 (31.6%,11.0%) 相比.
- 家庭CRC病史,血和便隐性血液,特别是在组合中,显示出最高的PDR和ADR,这表明检测能力提高.
结论:
- 在CRC查策略中将特定的临床表现如血和便隐性血液检测纳入CRC查策略可以显著提高检测率.
- 这些发现表明,对CRC查采取了更个性化的方法,超越了传统的风险因素.
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