Terhaar sive Droste Jochim S, van Wanrooij Roy L J, Morsink Linde M, van der Hulst René W M, Craanen Mike E, Bartelsman Joep W F M, Meijer Gerrit A, Mulder Chris J J
VU Medisch Centrum, Amsterdam, Afd. Maag-, darm- en leverziekten, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A731.
To map the locations of advanced colorectal neoplasia in patients referred for colonoscopy or sigmoidoscopy and to compare the yield of advanced neoplasia and the distribution of advanced neoplasia per indication for endoscopy.
Observational.
In a multicentre survey in North Holland, the Netherlands (n = 18 hospitals), data on all colonoscopies and sigmoidoscopies performed during a three-month period in 2005 were analyzed. The locations and the histological features of all colonic neoplasia and the indications for endoscopy were recorded. Advanced neoplasm was defined as adenoma >or=10 mm in size, an adenoma with any villous features, or high-grade dysplasia or adenocarcinoma.
A total of 4623 patients underwent a total colonoscopy and 3004 patients underwent sigmoidoscopy. The prevalence of advanced neoplasia was 13% on colonoscopy and 6% on sigmoidoscopy. Of the advanced neoplasia found on colonoscopy, 67% were located in the distal colon and 33% in the proximal colon. Of the patients with advanced neoplasia in the proximal colon (n = 228), 51% had no abnormalities in the distal colon. The percentage of advanced neoplasia in the proximal colon varied from 23% in patients younger than 50 years to 41% in patients aged 80 years and older. Depending on the indication for endoscopy, the prevalence of advanced neoplasia in the proximal colon varied from 11-57%.
Of the advanced colorectal neoplasms 33% were located in the proximal colon. With increasing age, a shift in tumour localization occurs from distal to proximal in the colon. Colonoscopy is the preferred method for the endoscopic diagnosing of colorectal neoplasia.
绘制接受结肠镜检查或乙状结肠镜检查患者中进展期结直肠肿瘤的位置，并比较进展期肿瘤的检出率以及每种内镜检查指征下进展期肿瘤的分布情况。
观察性研究。
在荷兰北荷兰省的一项多中心调查中（n = 18家医院），分析了2005年三个月期间所有结肠镜检查和乙状结肠镜检查的数据。记录了所有结肠肿瘤的位置、组织学特征以及内镜检查指征。进展期肿瘤定义为大小≥10毫米的腺瘤、具有任何绒毛状特征的腺瘤、高级别上皮内瘤变或腺癌。
共有4623例患者接受了全结肠镜检查，3004例患者接受了乙状结肠镜检查。结肠镜检查中进展期肿瘤的患病率为13%，乙状结肠镜检查中为6%。在结肠镜检查中发现的进展期肿瘤，67%位于结肠远端，33%位于结肠近端。在近端结肠有进展期肿瘤的患者中（n = 228），51%的远端结肠无异常。近端结肠进展期肿瘤的百分比在50岁以下患者中为23%，在80岁及以上患者中为41%。根据内镜检查指征，近端结肠进展期肿瘤的患病率在11%至57%之间。
33%的进展期结直肠肿瘤位于近端结肠。随着年龄的增长，结肠肿瘤的定位从远端向近端转移。结肠镜检查是内镜诊断结直肠肿瘤的首选方法。
