结肠镜检查中的腺瘤检出率：指征是一个预测指标吗？

Adenoma Detection Rate in Colonoscopy: Is Indication a Predictor?

作者信息

Yang Phillip F, Wong Shing W

机构信息

*Department of Surgery, Prince of Wales Hospital †Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales ‡Department of Surgery, Prince of Wales Private Hospital, NSW, Australia.

出版信息

Surg Laparosc Endosc Percutan Tech. 2016 Apr;26(2):156-61. doi: 10.1097/SLE.0000000000000253.

DOI:10.1097/SLE.0000000000000253

PMID:26813239

Abstract

PURPOSE

To describe factors that may influence adenoma detection rate (ADR), with an emphasis on the indication for colonoscopy.

METHODS

Consecutive colonoscopies performed by a single endoscopist between January 2008 and December 2014 were reviewed. Indications for colonoscopy were tested for association with ADR after adjusting for age and sex.

RESULTS

A total of 2648 colonoscopies were analyzed. Adenomas were detected in 630 patients (23.8%). Overall ADR was 22.9% in patients undergoing screening colonoscopy. ADR was higher in fecal occult blood test-triggered screening colonoscopies (32%) than colonoscopies performed for patients with a family history of colorectal cancer (21.7%) or asymptomatic average-risk individuals (20.4%) (P=0.05). ADR was 36.1% in patients undergoing surveillance colonoscopy and ranged from 12% to 30% in patients with gastrointestinal symptoms undergoing diagnostic colonoscopy.

CONCLUSIONS

ADR differs depending on whether the indication is screening, surveillance, or diagnosis. Within screening colonoscopies, ADR seems to be higher in patients with a positive fecal occult blood test.

摘要

目的

描述可能影响腺瘤检出率（ADR）的因素，重点关注结肠镜检查的适应证。

方法

回顾了2008年1月至2014年12月期间由一名内镜医师连续进行的结肠镜检查。在对年龄和性别进行校正后，对结肠镜检查的适应证与ADR之间的关联进行了测试。

结果

共分析了2648例结肠镜检查。630例患者（23.8%）检测到腺瘤。接受筛查结肠镜检查的患者总体ADR为22.9%。粪便潜血试验触发的筛查结肠镜检查的ADR（32%）高于为有结直肠癌家族史的患者（21.7%）或无症状平均风险个体（20.4%）进行的结肠镜检查（P=0.05）。接受监测结肠镜检查的患者ADR为36.1%，接受诊断性结肠镜检查的有胃肠道症状的患者ADR在12%至30%之间。