邹夏慧 刘敦菊 姜慧英 　詹晓文 程平

【摘要】 目的：分析2015-2019年江西南昌市西湖区结直肠癌筛查结果，为本地区结直肠癌的早期预防工作提供参考。方法：采用填写危险因素评估问卷结合检测粪便隐血试验（FOBT）筛选出高风险人群进行结直肠镜检查，发现病变进行活检并送病理学检查。比较不同性别、年龄筛查人群的结直肠病变情况。结果：2015年8月-2019年12月，共计22 578人参加筛查，5 412例判定为高风险人群，阳性率为23.97%，共1 573例接受肠镜检查，其中男682例（43.36%），女891例（56.64%），平均年龄（54.02±8.86）岁;各年龄段的高风险人群中女性占比均高于男性;高风险人群中50～59岁占比最高（36.30%），其次为40～49岁（35.03%），70～74岁占比最少（4.58%）。1 573例肠镜检查者中，584例发现不同程度阳性病变并活检，病变检出率为37.12%，分别为男308例（45.16%），女276例（30.98%），其中非腺瘤性息肉/炎性病变263例（16.72%），非进展期腺瘤224例（14.24%），进展期腺瘤79例（5.02%），结直肠癌18例（1.14%）。男性的总体病变检出率、非进展期腺瘤检出率、进展期腺瘤检出率均高于女性（P<0.05）;随着年龄的增加，总体病变、非进展期腺瘤、进展期腺瘤及结直肠癌检出率均呈上升趨势（P<0.05）。60～69岁患结直肠癌人数最高，患病部位为乙状结肠的占比最高，占50.0%（9/18）。结论：结直肠癌筛查项目有效地提高了该地区居民结直肠癌及腺瘤检出率，后期工作中，加强关注男性及年长人群。

【关键词】 结直肠癌 筛查 南昌市西湖区 早期预防

Analysis of Colorectal Cancer Screening Results in Xihu District of Nanchang City from 2015 to 2019/ZOU Xiahui， LIU Dunju， JIANG Huiying， ZHAN Xiaowen， CHENG Ping. //Medical Innovation of China， 2021， 18（34）： -172

[Abstract] Objective： To analyze the screening results of colorectal cancer in Xihu District， Nanchang City， Jiangxi Province from 2015 to 2019， and to provide reference for early prevention of colorectal cancer in this area. Method： High-risk people were screened out by filling out the risk factor assessment questionnaire combined with fecal occult blood test （FOBT） for colorectal endoscopy， and the lesions were detected for biopsy and pathological examination. The colorectal lesions of different genders and ages were compared. Result： From August 2015 to December 2019， a total of 22 578 people were screened， and 5 412 patients were identified as high-risk population with a positive rate of 23.97%. A total of 1 573 patients underwent colonoscopy， including 682 males （43.36%） and 891 females （56.64%）， with an average age of （54.02±8.86） years. The proportions of females in high-risk group were higher than those of males in all age groups. In the high-risk group， 50-59 years old accounted for the highest proportion （36.30%）， followed by 40-49 years old （35.03%）， 70-74 years old accounted for the least proportion （4.58%）. Among 1 573 patients underwent colonoscopy， 584 patients were found to had various degrees of positive lesions and biopsy. The detection rate was 37.12%， including 308 males （45.16%） and 276 females （30.98%）， including 263 non-adenomatous polyps/inflammatory lesions （16.72%） and 224 non-advanced adenomas （14.24%）. There were 79 cases of advanced adenoma （5.02%） and 18 cases of colorectal cancer （1.14%）. The detection rates of pathological changes， non-progressive adenoma and progressive adenoma in male were higher than those in female （P<0.05）. With the increase of age， the detection rates of overall lesions， non-advanced adenoma， advanced adenoma and colorectal cancer were increased （P<0.05）. The number of colorectal cancer patients aged 60-69 years was the highest， and the proportion of patients with sigmoid colon was the highest， accounting for 50.0% （9/18）. Conclusion： The colorectal cancer screening program has effectively improved the detection rate of colorectal cancer and adenoma among residents in this area. In the later work， more attention should be paid to the male and elderly groups.

[Key words] Colorectal cancer Screening Xihu District Nanchang City Early prevention

First-author’s address： Nanchang Third Hospital， Nanchang 330009， China

doi：10.3969/j.issn.1674-4985.2021.34.041

结直肠癌（colorectal cancer ，CRC）是常见的恶性肿瘤，2018年全球统计显示占全部恶性肿瘤发病率第三位，死亡率第二位[1]。随着我国人民生活水平的不断提高和饮食结构的改变，结直肠癌的发病率也呈持续上升趋势，在我国恶性肿瘤中发病率占第三位，尤其在城市地区中为第二位的高发肿瘤，而死亡率占恶性肿瘤中第五位，严重危害人民健康[2]。……