Hixson L J, Fennerty M B, Sampliner R E, McGee D, Garewal H
Section of Gastroenterology, Tucson VA Medical Center, AZ 85724.
J Natl Cancer Inst. 1990 Nov 21;82(22):1769-72. doi: 10.1093/jnci/82.22.1769.
An important determinant in interpreting the results of colorectal polyp chemoprevention trials is the rate of polyps missed during colonscopic examination. We prospectively examined 90 patients by tandem colonoscopy performed by two alternating examiners. In 69 (76.7%) patients, 221 neoplastic lesions were documented histologically. Of a total of 58 lesions detected in 31 patients, no neoplastic lesion greater than or equal to 10 mm in size was missed; 16% of diminutive (less than or equal to 5 mm) neoplastic polyps and 12.3% of medium-sized (6-9 mm) neoplastic polyps were missed by the first examiner. We conclude that an experienced colonoscopist will miss about 15% of colorectal neoplastic polyps less than 10 mm in size in the setting of adequate bowel preparation. Large (greater than or equal to 10 mm) polyps were rarely missed, however, with the "miss" rate in our study equal to 0, with a 95% confidence limit of 4.64%.
解读结直肠息肉化学预防试验结果的一个重要决定因素是结肠镜检查过程中漏诊息肉的发生率。我们对90例患者进行了前瞻性研究，由两名交替的检查者进行串联结肠镜检查。69例（76.7%）患者经组织学证实有221个肿瘤性病变。在31例患者中总共检测出58个病变，大小大于或等于10毫米的肿瘤性病变无一漏诊；第一位检查者漏诊了16%的微小（小于或等于5毫米）肿瘤性息肉和12.3%的中等大小（6 - 9毫米）肿瘤性息肉。我们得出结论，在肠道准备充分的情况下，经验丰富的结肠镜检查者会漏诊约15%的大小小于10毫米的结直肠肿瘤性息肉。然而，大的（大于或等于10毫米）息肉很少漏诊，在我们的研究中“漏诊”率为0，95%置信区间为4.64%。
