Lenhart Dipti K, Zalis Michael E
Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
Gastrointest Endosc Clin N Am. 2010 Apr;20(2):227-37. doi: 10.1016/j.giec.2010.02.002.
Colorectal polyps less than 6 mm in size pose a negligible risk to the development of colorectal carcinoma. The sensitivity and specificity for detection of diminutive lesions on all available examinations including CT colonography (CTC) and optical colonoscopy (OC) is relatively low. In the context of regular screening, the low clinical significance and slow to negligible growth of diminutive polyps, as well as the low detection performance of CTC and OC for these lesions, would contribute to wasted health care resource and excess morbidity if each diminutive polyp were referred for potential resection. Respect for patient safety, attention to proper use of resources, and appropriate focus on larger, clinically significant polyps lead the authors to the conclusion that colonic polyps of less than 6 mm should not be separately reported.
直径小于6毫米的结直肠息肉发展为结直肠癌的风险可忽略不计。包括CT结肠成像(CTC)和光学结肠镜检查(OC)在内的所有现有检查手段对微小病变的检测敏感性和特异性相对较低。在常规筛查中,如果将每一个微小息肉都送去做潜在切除,那么微小息肉的临床意义不大、生长缓慢至可忽略不计,以及CTC和OC对这些病变的低检测性能,都会造成医疗资源的浪费和额外的发病率。出于对患者安全的考虑、对资源合理使用的关注以及对更大的、具有临床意义的息肉的适当关注,作者得出结论,直径小于6毫米的结肠息肉不应单独报告。