中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2008年
9期
466-468
,共3页
沈俊%莫善兢%蔡三军%赵伟民%顾伟力%管祖庆%张绍珍%陈洁
瀋俊%莫善兢%蔡三軍%趙偉民%顧偉力%管祖慶%張紹珍%陳潔
침준%막선긍%채삼군%조위민%고위력%관조경%장소진%진길
结直肠癌%随访研究%结肠镜检查%肿瘤,多原发性%腺瘤
結直腸癌%隨訪研究%結腸鏡檢查%腫瘤,多原髮性%腺瘤
결직장암%수방연구%결장경검사%종류,다원발성%선류
Colorectal cancer%Follow up studies%Colonoscopy%Neoplasm,multiple primary%Adenoma
目的 通过大肠镜检查在临床的广泛应用,防止和降低多原发大肠癌的发生.方法 分析1986年6月至2007年6月大肠癌外科术后进行无症状定期结肠镜随访2762例患者的资料,随访方法为术后3～6个月内首次肠镜检查,以后每年1次,连续3年.并与1981年9月至1986年5月大肠癌术后有症状者结肠镜复查的218例资料进行对比.结果 2762例中发现多原发癌48例,其中同时多原发癌39例(1.4%),异时多原发癌9例(0.3%);TNM分类Ⅰ期癌6例,Ⅱ期癌31例,Ⅲ期癌11例.发现腺瘤583例(21.1%),病理检查证实17例(3.2%)为浸润性早期癌,58例(9.9%)为高级别上皮内瘤变.218例有症状检查者共发现多原发癌27例(12.4%),明确Ⅰ期癌4例,Ⅱ期癌6例,Ⅲ期癌16例.发现腺瘤29例(13.3%).结论 无症状定期结肠镜随访检查发现多原发癌明显低于有症状者,发现的早期癌、腺瘤比例高,说明无症状定期检查,能防止和降低多原发大肠癌的发生.
目的 通過大腸鏡檢查在臨床的廣汎應用,防止和降低多原髮大腸癌的髮生.方法 分析1986年6月至2007年6月大腸癌外科術後進行無癥狀定期結腸鏡隨訪2762例患者的資料,隨訪方法為術後3～6箇月內首次腸鏡檢查,以後每年1次,連續3年.併與1981年9月至1986年5月大腸癌術後有癥狀者結腸鏡複查的218例資料進行對比.結果 2762例中髮現多原髮癌48例,其中同時多原髮癌39例(1.4%),異時多原髮癌9例(0.3%);TNM分類Ⅰ期癌6例,Ⅱ期癌31例,Ⅲ期癌11例.髮現腺瘤583例(21.1%),病理檢查證實17例(3.2%)為浸潤性早期癌,58例(9.9%)為高級彆上皮內瘤變.218例有癥狀檢查者共髮現多原髮癌27例(12.4%),明確Ⅰ期癌4例,Ⅱ期癌6例,Ⅲ期癌16例.髮現腺瘤29例(13.3%).結論 無癥狀定期結腸鏡隨訪檢查髮現多原髮癌明顯低于有癥狀者,髮現的早期癌、腺瘤比例高,說明無癥狀定期檢查,能防止和降低多原髮大腸癌的髮生.
목적 통과대장경검사재림상적엄범응용,방지화강저다원발대장암적발생.방법 분석1986년6월지2007년6월대장암외과술후진행무증상정기결장경수방2762례환자적자료,수방방법위술후3～6개월내수차장경검사,이후매년1차,련속3년.병여1981년9월지1986년5월대장암술후유증상자결장경복사적218례자료진행대비.결과 2762례중발현다원발암48례,기중동시다원발암39례(1.4%),이시다원발암9례(0.3%);TNM분류Ⅰ기암6례,Ⅱ기암31례,Ⅲ기암11례.발현선류583례(21.1%),병리검사증실17례(3.2%)위침윤성조기암,58례(9.9%)위고급별상피내류변.218례유증상검사자공발현다원발암27례(12.4%),명학Ⅰ기암4례,Ⅱ기암6례,Ⅲ기암16례.발현선류29례(13.3%).결론 무증상정기결장경수방검사발현다원발암명현저우유증상자,발현적조기암、선류비례고,설명무증상정기검사,능방지화강저다원발대장암적발생.
Objective To evaluate the colonoscopy surveillance in colorectal cancer patients after surgical removal of the tumor.Methods From June 1986 to June 2007,2762 asymptomatic patients who had underwent operation for colorectal cancer were put into colonoscopy surveillance.They had the first examination 3-6 months after the operation,and were re-examined once a year thereafter for 3 years.The follow-up findings were compared with those from the 218 symptomatic patients who had colorectal cancer surgery from September 1981 to May 1986.Results In 2762 asymptomatic patients,48 cases of multiple primary cancer were detected,in which 39 cases(1.4%) were found at one examination and 9 cases(0.3%)at different examination.The TNM staging of these lesions included stage Ⅰ in 6,stage Ⅱ in 31 and stage Ⅲ in 11.During the surveillance,583 cases(21.1%) of adenoma were detected and endoscopically resected,in which 17(3.2%) were invasive early cancer and 58(9.9%) were high grade dysplasia.In 218 patients with symptoms,29 cases(13.3%) of adenoma and 27 cases( 12.4%) of cancer were detected,including 4 cases of stage Ⅰ cancer,6 of stage Ⅱ and 16 of stage Ⅲ.Conclusion Colonoscopy surveillance in colorectal cancer patients after surgery is important in finding precancerous lesion and early stage cancer,and is recommended in all patients.
