Lieberman D A, Smith F W
Department of Medicine, Portland Veterans Administration Medical Center, OR 97207.
Arch Intern Med. 1988 Feb;148(2):473-5.
The American Cancer Society now advocates screening asymptomatic populations over the age of 40 to 50 years for colonic malignancy. It is possible, however, that fecal occult blood testing and sigmoidoscopy to 60 cm would fail to identify patients with adenomatous polyps located only in the proximal colon. The purpose of this study was to determine how many patients without polyps in the distal 60 cm of the colon would have more proximal lesions. Ninety-eight consecutive patients with positive fecal blood test results or suspicious barium enema results were studied, using the assumption that if they had been seen six months earlier, when asymptomatic, they would have been candidates for screening examination. Forty-one (42%) of 98 patients had adenomatous polyps or cancer, and 15 (37%) of these patients had isolated proximal lesions. The polyp detection rate from 0 to 60 cm was significantly less than the detection rate for a full colonoscopy (27% vs 42%). We conclude that isolated proximal colonic polyps may be common.
美国癌症协会目前提倡对40至50岁以上的无症状人群进行结肠恶性肿瘤筛查。然而，粪便潜血试验及60厘米乙状结肠镜检查有可能无法识别仅位于近端结肠的腺瘤性息肉患者。本研究的目的是确定在结肠远端60厘米内无息肉的患者中有多少会有更靠近近端的病变。对98例连续的粪便潜血试验结果阳性或钡剂灌肠结果可疑的患者进行了研究，假设如果他们在无症状时提前6个月就诊，他们就会成为筛查检查的对象。98例患者中有41例（42%）患有腺瘤性息肉或癌症，其中15例（37%）患者有孤立的近端病变。0至60厘米的息肉检出率明显低于全结肠镜检查的检出率（27%对42%）。我们得出结论，孤立的近端结肠息肉可能很常见。
