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美国癌肿学会推荐对结直肠癌非高危人群作二级预防,即从40岁开始每年一次肛指检查,50岁开始作大使隐血试验和可曲式乙状结肠镜(FS)检查,如发现腺瘤,需作全结肠检查,以期发现和切除同时发生的肿瘤性病变,并定期随访切除再生病变。如FS未发现腺癌的指征,无需作常规检查近段结肠,每3～5年做一次FS检查既足够。作者选择114例大于50岁男性受试者,均无任何结直肠肿瘤的症状和体征,结肠镜检未发现如溃疡性结肠炎或息肉等肿瘤危险因素,直系亲属也无结直肠病史。同期内做FS和结肠镜的全结肠检查。目的为确定男性病人中FS(长60cm)能达到肠段内无腺瘤而近侧结肠有孤立性腺瘤的发生率。结果114例中47例(41％)发现腺癌共88枚,直径为2～2.5 mm·10％大于1.0cm。其分布直肠为13(15％),乙状结肠24(27％),降结肠11(13％),横结肠12(14％),升结肠16(18％),盲肠12(14％)。FS未发现有腺瘤的84例中17例(20％),结肠镜发现其近侧结肠有腺瘤,FS发现有腺瘤的30例中9例(30％)近
The American Cancer Society recommends secondary prevention of colorectal cancer in non-at-risk populations, that is, an anal finger examination from the age of 40, an occult occult blood test at the age of 50, and a flexible sigmoidoscopy (FS) examination. A total colon examination is required to detect and remove simultaneous neoplastic lesions and regular follow-up resection of the regenerative lesions. If FS did not find the indication of adenocarcinoma, it was not necessary to routinely check the proximal colon and it was sufficient to perform a FS examination every 3 to 5 years. The authors selected 114 male subjects over 50 years of age who did not have any signs or symptoms of colorectal cancer. Colonoscopy did not find any risk factors such as ulcerative colitis or polyps, and immediate family members had no history of colorectal disease. During the same period, a colonic examination with FS and colonoscopy was performed. The purpose was to determine the incidence of FS (60 cm in length) in male patients without adenoma in the bowel and solitary adenoma in the proximal colon. Results A total of 88 adenocarcinomas were found in 47 (41%) of the 114 patients, and the diameter was 2 to 2.5 mm and 10% was greater than 1.0 cm. The distribution of the rectum was 13 (15%), sigmoid colon 24 (27%), descending colon 11 (13%), transverse colon 12 (14%), ascending colon 16 (18%), cecum 12 (14%). Seventy-eight (84%) of the 84 patients with adenomas had no adenoma. Colonoscopy showed adenomas in the proximal colon. Among the 30 patients with FS who had adenomas, 9 (30%) were found.