JAMA:结直肠癌筛查方法对完成率以及异常检出率的长期影响研究

2017-09-06 zhangfan MedSci原创

研究认为,对于50-64岁的结肠癌风险人群,接受粪便免疫化学试验或结肠镜检查可提高患者3年的检查完成率,而结肠镜的病变异常检出率高于粪便免疫化学试验

研究发现就短期而言,结肠癌粪便免疫化学试验(FIT)的效果优于结肠镜检测,但长期持续性效果尚不清楚。近日研究人员比较了3年内便免疫化学试验与结肠镜就结肠癌筛查的效果差异。

研究人员开展一项实用随机临床试验,从2013年3月持续至2016年7月,5999名50-64的风险人群参与,参与者随机进行FIT检查(n=2400)、结肠镜检查(n=2400)或常规护理与临床筛查(n=1199),对所有参与者进行年度的复查。研究的主要终点是筛查完成率,次要终点包括任何腺瘤或晚期肿瘤发现率。

参与者平均年龄56岁,61.9%为女性。研究发现,结肠镜组筛查完成率为38.4%,FIT组为28.0%,常规检查组为10.7%。相比于常规检查,结肠镜组以及FIT组的完成率更高;相比于常规检查,结肠镜组以及FIT组的腺瘤与晚期肿瘤检出率更高(结肠镜组腺瘤检出率为10.3%,晚期肿瘤检出率为3.1%;FIT组腺瘤检出率为1.3%,晚期肿瘤检出率为0.7%)。各组未发生检查相关的不良事件。

研究认为,对于50-64岁的结肠癌风险人群,接受粪便免疫化学试验或结肠镜检查可提高患者3年的检查完成率,而结肠镜的病变异常检出率高于粪便免疫化学试验。

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-19 虈亣靌

    希望中国医疗卫生能给世界卫生带来一点贡献.

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-11 大爰

    学习了谢谢分享!!

    0

  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-08 大爰

    学习并分享!!

    0

  7. 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likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Fri Sep 08 16:16:34 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1452975, encodeId=4d9d14529e574, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri Sep 08 01:30:00 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241187, encodeId=25ff24118eb1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:15:07 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241186, encodeId=f7c02411869d, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:14:50 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241173, encodeId=43792411e3db, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1904789, encodeId=77dc1904e89c7, content=<a href='/topic/show?id=ae97625036d' target=_blank style='color:#2F92EE;'>#检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62503, encryptionId=ae97625036d, topicName=检出率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Thu Mar 22 12:30:00 CST 2018, time=2018-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042428, encodeId=ca2a20424282d, content=<a href='/topic/show?id=9f0ae59339a' target=_blank style='color:#2F92EE;'>#筛查方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75933, encryptionId=9f0ae59339a, topicName=筛查方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7f52347, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Sep 19 19:49:10 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242827, encodeId=453b24282e2a, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Sep 11 10:37:02 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241801, encodeId=d2b42418014d, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Fri Sep 08 16:16:34 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1452975, encodeId=4d9d14529e574, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri Sep 08 01:30:00 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241187, encodeId=25ff24118eb1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:15:07 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241186, encodeId=f7c02411869d, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:14:50 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241173, encodeId=43792411e3db, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-06 luominglian113

    学习了.谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1904789, encodeId=77dc1904e89c7, content=<a href='/topic/show?id=ae97625036d' target=_blank style='color:#2F92EE;'>#检出率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62503, encryptionId=ae97625036d, topicName=检出率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce68183, createdName=xiongke010, createdTime=Thu Mar 22 12:30:00 CST 2018, time=2018-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042428, encodeId=ca2a20424282d, content=<a href='/topic/show?id=9f0ae59339a' target=_blank style='color:#2F92EE;'>#筛查方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75933, encryptionId=9f0ae59339a, topicName=筛查方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7f52347, createdName=soongzhihua, createdTime=Mon Aug 13 14:30:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053263, encodeId=bdc920532633b, content=<a href='/topic/show?id=6d7796998e0' target=_blank style='color:#2F92EE;'>#长期影响#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96998, encryptionId=6d7796998e0, topicName=长期影响)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Nov 22 19:30:00 CST 2017, time=2017-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245753, encodeId=e716245e536a, content=希望中国医疗卫生能给世界卫生带来一点贡献., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, 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likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Fri Sep 08 16:16:34 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1452975, encodeId=4d9d14529e574, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri Sep 08 01:30:00 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241187, encodeId=25ff24118eb1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:15:07 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241186, encodeId=f7c02411869d, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:14:50 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241173, encodeId=43792411e3db, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-06 luominglian113

    学习了.谢谢分享

    0

  10. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Sep 19 19:49:10 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242827, encodeId=453b24282e2a, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Sep 11 10:37:02 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241801, encodeId=d2b42418014d, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Fri Sep 08 16:16:34 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1452975, encodeId=4d9d14529e574, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri Sep 08 01:30:00 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241187, encodeId=25ff24118eb1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:15:07 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241186, encodeId=f7c02411869d, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Wed Sep 06 23:14:50 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241173, encodeId=43792411e3db, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 06 22:53:59 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-06 虈亣靌

    学习一下谢谢分享

    0

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氟尿嘧啶类药物是结直肠癌(CRC)治疗的必要组成部分,患者通常更愿意选择口服片剂,因其安全、使用方便,但口服与静脉(IV)剂型的作用真的完全相同吗?这项研究发现CRC无论是治愈性治疗还是姑息性治疗时,IV和口服氟尿嘧啶的作用并不完全相同。

病例讨论:结肠癌肺转移MDT诊疗

一般情况:KPS评分90分,有吸烟史20+年,不规律饮酒史20+年,无高血压、糖尿病、冠心病、慢支等病史