抗击结肠镜后结肠直肠癌:从试验和队列研究的洞察力
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
结肠镜后结肠直肠癌 (PCCRC) 是一个重大问题,通常是由结肠镜期间错过的病变引起的. 提高结肠镜检查的质量和技术对于降低PCCRC风险和加强癌症预防至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 结肠直肠癌 (CRC) 是一个主要的全球健康问题,在发病率上排名第三,癌症相关死亡率排名第二.
- 结肠镜对于CRC查和腺瘤去除至关重要,但结肠镜后结肠直肠癌 (PCCRC) 表示质量差距.
- 缺失的病变,特别是非多聚体病变或近邻结肠病变,是PCCRC的主要驱动因素,约占80%的病例.
研究的目的:
- 审查目前针对旨在减少PCCRC的干预措施的临床研究.
- 确定质量提升努力与PCCRC风险之间的关联.
- 为PCCRC预防指导未来的临床研究方向.
主要方法:
- 专注于对当前临床研究的审查.
- 优先进行随机对照试验和队列研究.
- 综合了有关改善结肠镜检查质量和性能的干预措施的证据.
主要成果:
- PCCRC强调了当前结肠镜实践中存在的严重缺陷.
- 错过的病变,特别是非多聚类型和近位病变,是PCCRC的主要原因.
- 目前的努力集中在提高结肠镜检查质量和开发新技术上.
结论:
- 通过可测量指标和先进技术提高结肠镜检查质量对于预防PCCRC至关重要.
- 将干预与PCCRC风险联系在一起的证据对于优化结肠镜查疗效至关重要.
- 需要进行进一步的临床研究,以确定预防PCCRC的未来方向.
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