Leung William C Y, Foo Dominic C C, Chan T T, Chiang M F, Lam Allan H K, Chan Heywood H W, Cheung C Cl
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Hong Kong Med J. 2016 Feb;22(1):70-7. doi: 10.12809/hkmj154685. Epub 2016 Jan 8.
Colorectal cancer is one of the top three cancers in the world in terms of incidence. Colonoscopy, which many regard as the gold standard in diagnosis of colonic polyps and neoplasm, is costly, invasive and labour-intensive, and deemed an unsuitable population-wide index screening tool. Alternative modalities, including guaiac and immunohistochemical faecal occult blood tests, computed tomographic colonography, colon capsule endoscopy, flexible sigmoidoscopy, and double-contrast barium enema are available. The procedures, test characteristics, and their implications are reviewed. Immunohistochemical faecal occult blood testing appears to be the most suitable population-wide screening test for an average-risk population, with flexible sigmoidoscopy as an alternative. More evidence is needed to determine the role of computed tomographic colonography and colon capsule endoscopy in colorectal cancer screening.
就发病率而言，结直肠癌是全球三大癌症之一。结肠镜检查被许多人视为诊断结肠息肉和肿瘤的金标准，但它成本高昂、具有侵入性且耗费人力，被认为不是适合全人群的指标筛查工具。还有其他一些检查方式可供选择，包括愈创木脂和免疫组化粪便潜血试验、计算机断层结肠成像、结肠胶囊内镜检查、乙状结肠镜检查以及双对比钡剂灌肠。本文对这些检查方法、检测特性及其意义进行了综述。免疫组化粪便潜血检测似乎是最适合一般风险人群的全人群筛查检测方法，乙状结肠镜检查可作为替代方法。需要更多证据来确定计算机断层结肠成像和结肠胶囊内镜检查在结直肠癌筛查中的作用。
