Farca Belsaguy A, Presenda Miller F, de la Mora Levy G
Servicio de Gastroenterología y Unidad de Endoscopia Terapéutica, Hospital Gral. Dr. Manuel Gea González, México D.F.
Rev Gastroenterol Mex. 1996 Jan-Mar;61(1):27-30.
The aim of this study was to determine the frequency of adenomas as well as sensitivity, specificity, positive and negative predictive values of FS for polyp screening in two groups of asymptomatic individuals using colonoscopy (CP) as the gold standard.
Flexible sigmoidoscopy (FS) is the screening procedure of choice for polyps and colorectal carcinoma (CRC) in asymptomatic individuals. However, the validity of this approach has been questioned, specially in subjects with a family history of CRC.
A total of 92 asymptomatic individuals were included in two groups: group A: with a family history (1st or 2nd degree relatives) of polyps or CRC (fifty-eight), and group B: without a family history and > 50 years (thirty-four). FS was simulated with the videocolonoscope until 60 cm, and was continued into the cecum. The number, type and localization of polyps were noted for each, FS and CP. The values mentioned previously were calculated according to established formulas. Comparisons were performed using Chi square test.
Adenomas were found in twenty individuals in group A (34.4%) and 7 in group B (20.5%), p = NS. Sensitivity for FS in group A was 42% vs 71% in group B, with a negative predictive value of 44.5 and 93%, respectively.
Colonoscopy is probably the screening procedure of choice in individuals with a family history of polyps or CRC. The utility of FS for screening purposes in asymptomatic individuals without a family history seems adequate, although more studies are required in different populations in our country.
本研究旨在以结肠镜检查（CP）作为金标准，确定两组无症状个体中腺瘤的发生率以及乙状结肠镜检查（FS）用于息肉筛查的敏感性、特异性、阳性预测值和阴性预测值。
乙状结肠镜检查（FS）是无症状个体息肉和结直肠癌（CRC）的首选筛查方法。然而，这种方法的有效性受到了质疑，特别是在有CRC家族史的人群中。
总共92名无症状个体被纳入两组：A组：有息肉或CRC家族史（一级或二级亲属）（58人），B组：无家族史且年龄>50岁（34人）。用电子结肠镜模拟乙状结肠镜检查至60 cm，并继续检查至盲肠。记录每次FS和CP时息肉的数量、类型和位置。根据既定公式计算上述值。采用卡方检验进行比较。
A组20人（34.4%）发现腺瘤，B组7人（20.5%）发现腺瘤，p =无显著性差异。A组FS的敏感性为42%，B组为71%，阴性预测值分别为44.5%和93%。
结肠镜检查可能是有息肉或CRC家族史个体的首选筛查方法。对于无家族史的无症状个体，FS用于筛查的效用似乎足够，尽管我国不同人群还需要更多研究。
