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[结肠镜检查后结直肠癌:间隔期结直肠癌的病因与预防]

[Post-colonoscopy Colorectal Cancer: Causes and Prevention of Interval Colorectal Cancer].

作者信息

Lee Jong Yoon, Lee Jong Hoon

机构信息

Department of Gastroenterology, Dong-A University Hospital, Busan, Korea.

出版信息

Korean J Gastroenterol. 2020 Jun 25;75(6):314-321. doi: 10.4166/kjg.2020.75.6.314.

Abstract

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in the worldwide. Colonoscopy is the gold standard for screening and surveillance of CRC. Removing adenomas by colonoscopy has lowered the incidence and mortality of CRC. However, colonoscopy is imperfect for detection of colorectal neoplasia. After a colonoscopy that is negative for malignancy, CRC can be diagnosed. These are termed as post-colonoscopy CRC (PCCRC). The proportion of PCCRC, among all CRC was reported to be 1.8% to 9.0%. It occurred 2.4 times more in the right colon than in the left colon. The causes of PCCRC are missed lesions, incomplete resection, and new lesions. Among these causes, missed lesion and incomplete resection are procedural factors and preventable. Therefore, it is necessary to improve the quality of colonoscopy to minimize the occurrence of PCCRC.

摘要

结直肠癌(CRC)是全球第三大常见诊断癌症和第四大癌症死亡原因。结肠镜检查是CRC筛查和监测的金标准。通过结肠镜检查切除腺瘤降低了CRC的发病率和死亡率。然而,结肠镜检查在检测结直肠肿瘤方面并不完美。在结肠镜检查结果为恶性阴性后,仍可诊断出CRC。这些被称为结肠镜检查后CRC(PCCRC)。据报道,PCCRC在所有CRC中所占比例为1.8%至9.0%。它在右半结肠的发生率比左半结肠高2.4倍。PCCRC的原因是漏诊病变、切除不完全和新病变。在这些原因中,漏诊病变和切除不完全是操作因素,是可以预防的。因此,有必要提高结肠镜检查的质量,以尽量减少PCCRC的发生。

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