Gastroenterology:结肠镜后肠癌分类及影响因素

2020-01-11 MedSci MedSci原创

研究发现, 89%的结肠镜后肠癌是可以避免的

结肠镜后肠癌(PCCRC)是结肠镜检查阴性结果后发生的癌症。近日研究人员就PCCRC的病例及其原因,以量化可避免的PCCRC的比例。

研究人员对2010年1月1日至2017年12月31日间,107名PCCRC病例进行了回顾性分析。对于每一例,研究人员都回顾了临床,病理,放射学和内镜检查结果。根据世界内镜协会(WEO)的建议,研究人员对每一个病例进行了根本原因分析,将病变分为:可能漏诊的病变,预先检查充分;可能漏诊的病变,预先检查不充分;发现的病变,未切除;或可能不完全切除先前确定的病变。研究人员根据WEO肿瘤的分类和大小,确定了PCCRC是否可以归因于结肠镜检查者的技术或决策原因,以及PCCRC是否可以避免或不可避免。

在已鉴定的PCCRCs中,43%的患者是高危患者(炎症性肠病、既往的CRC、既往多发性大息肉或遗传性癌症综合征),66%位于肝脏弯曲的远端。统计发现,PCCRC病例中,19%的肠道准备不充分,只有36%的检查有足够的完整的照片记录。73%的PCCRCs的发展被确定为受技术性内镜因素的影响,13%的PCCRCs受管理因素影响,27%的PCCRCs受决策因素的影响。27%的PCCRCs被归类为可能的漏诊,事先检查充分;58%的PCCRCs被归类为可能的漏诊,预先检查不充分;8%的PCCRCs被归类为检测到有病变,但未切除;7%为先前观察到的病灶未完全切除,89%被认为是可以避免的。

研究发现, 89%的结肠镜后肠癌是可以避免的。

原始出处:


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    2020-06-04 许安
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    2020-01-13 zhouqu_8
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