Gastroenterology:结肠腺瘤漏诊相关因素研究

2019-09-02 MedSci MedSci原创

研究人员发现,右侧腺瘤不会增加结肠镜检查中漏诊的几率,腺瘤的大小和组织学特征与漏诊风险相关

统计发现间期结肠癌多发于右侧,其中一个原因可能是在结肠镜检查中右侧腺瘤的遗漏率较高。近日研究人员重新分析相关结肠镜数据,以评估与位置和其他因素相关的腺瘤漏诊率。

研究人员收集了8个随机串联试验的数据,其中2218名患者进行了诊断筛查结肠镜检查(49.8%的患者发现腺瘤)。考察因素包括:位置(左vs右,以脾曲为界)、腺瘤大小、形态和组织学特征。

研究发现,右侧位置不是腺瘤漏诊的独立危险因素(与左侧相比优势比[OR]:0.94)。与≤5 mm腺瘤相比,6-9mm腺瘤漏诊的OR值为0.62,≥10 mm腺瘤的漏诊OR值为0.51。与有蒂腺瘤相比,无蒂腺瘤(OR:1.82)和扁平腺瘤(OR:2.47)更容易漏诊。组织学特征与漏诊腺瘤 (高级上皮内瘤样腺瘤OR:0.68;无柄锯齿状腺瘤OR:0.87) 不相关。男性每次结肠镜检查的腺瘤数目(1.27)高于女性(0.86)。男性腺瘤漏诊率低于女性(男性漏诊腺瘤的OR:0.73)。

研究人员发现,右侧腺瘤不会增加结肠镜检查中漏诊的几率,腺瘤的大小和组织学特征与漏诊风险相关。

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    2020-03-25 许安
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    2019-09-04 thm112988

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