CAJ | 학술논문

目的对行冠状动脉造影(CAG)检查者,比较亚太地区结直肠筛选评分系统(APCS评分)和中国卫生部结直肠癌序贯筛查方案(卫生部标准)评判结直肠肿瘤高度危险人群的差异.方法分别采用APCS评分和卫生部标准对870例40～74岁接受CAG检查的患者资料进行回顾性分析.计量资料采用t检验,计数资料采用x2检验.结果 40～＜50岁患者共72例,按卫生部标准筛选出高度危险患者8例,按APCS评分无高度危险人群.50～74岁患者共798例,按APCS评分筛选出高度危险患者460例；CAG阴性组比例(34.7％)显著低于冠状动脉疾病(CAD)组(68.0％,x2=77.74,P＜0.01).按卫生部标准筛选出高度危险患者134例,CAG阴性组比例(17.7％)与CAD组(16.4％)间差异无统计学意义(P＞0.05).在50～74岁无一级亲属结直肠癌家族史的患者中,CAG阴性组有72例(29.0％)、CAD组有316例(57.5％)按APCS评分为高度危险,而按卫生部标准为非高度危险人群,其中男性吸烟者占90.5％ (351/388)；CAG阴性组有30例(12.1％)、CAD组有32例(5.8％)患者按APCS评分为中度危险,而按卫生部标准为高度危险人群,其中不吸烟的女性患者占75.8％(47/62).结论由APCS评分筛查出结直肠肿瘤高度危险患者的比例高于卫生部标准.对50～74岁、无一级亲属结直肠癌家族史的患者,APCS评分可能高估了男性吸烟者发生结直肠肿瘤的危险度,低估了不吸烟的女性患者的危险度.
목적 대행관상동맥조영(CAG)검사자,비교아태지구결직장사선평분계통(APCS평분)화중국위생부결직장암서관사사방안(위생부표준)평판결직장종류고도위험인군적차이.방법 분별채용APCS평분화위생부표준대870례40～74세접수CAG검사적환자자료진행회고성분석.계량자료채용t검험,계수자료채용x2검험.결과 40～＜50세환자공72례,안위생부표준사선출고도위험환자8례,안APCS평분무고도위험인군.50～74세환자공798례,안APCS평분사선출고도위험환자460례；CAG음성조비례(34.7％)현저저우관상동맥질병(CAD)조(68.0％,x2=77.74,P＜0.01).안위생부표준사선출고도위험환자134례,CAG음성조비례(17.7％)여CAD조(16.4％)간차이무통계학의의(P＞0.05).재50～74세무일급친속결직장암가족사적환자중,CAG음성조유72례(29.0％)、CAD조유316례(57.5％)안APCS평분위고도위험,이안위생부표준위비고도위험인군,기중남성흡연자점90.5％ (351/388)；CAG음성조유30례(12.1％)、CAD조유32례(5.8％)환자안APCS평분위중도위험,이안위생부표준위고도위험인군,기중불흡연적녀성환자점75.8％(47/62).결론 유APCS평분사사출결직장종류고도위험환자적비례고우위생부표준.대50～74세、무일급친속결직장암가족사적환자,APCS평분가능고고료남성흡연자발생결직장종류적위험도,저고료불흡연적녀성환자적위험도.
Objective To investigate the difference between Asia-Pacific Colorectal Screening (APCS) scoring system and colorectal cancer sequential screening criteria issued by the Health Ministry of China (China sequential criteria) in the evaluation of high-risk colorectal neoplasm in patients undergoing coronary artery angiography (CAG) examination.Methods The data of 870 patients aged from 40 to 74 who underwent CAG examination were retrospectively analyzed.The measurement data were analyzed by t test and the count data were aralyzed by x2 test.Results There were 72 patients aged from 40 to 49 years old.Among them,eight patients were stratified as high-risk population according to the Chinese sequential criteria; however there was no high-risk population by APCS.There were 798 patients aged from 50 to 74 years old.There were 460 patients stratified as high-risk population by APCS.The percentage of CAG negative group (34.7％) was significantly lower than that of the coronary artery disease (CAD) group (68.0％,x2 =77.74,P＜0.01).According to the Chinese sequential criteria,and there were 134 patients stratified as high-risk population,and there was no significant difference between the CAG negative group (17.7 ％) and the CAD group (16.4％,P＞0.05).Among the patients aged from 50 to 74 years old without family history of colorectal cancer in first-degree relatives,72 cases (29.0％) of the CAG negative group and 316 cases (57.5％) of the CAD group were stratified as high-risk according to APCS,however not stratified as high-risk by the Chinese sequential criteria.About 90.5 ％ (351/388) of them were male smokers.According to APCS,30 cases (12.1％) of the CAG negative group and 32 cases (5.8％) of the CAD group were stratified as middle-risk population,however stratified as high-risk population by the Chinese sequential criteria.About 75.8％ (47/62) of them were female non-smokers.Conclusions The percentage of patients stratified as high-risk population by APCS was higher than that by the Chinese sequential criteria.In patients aged from over 50 to 74 years old and without family history of colorectal cancer in first-degree relative,APCS maybe overestimated the risk degree of colorectal neoplasm in male smokers and underestimated the risk degree in female non-smokers.