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[目的]探讨江苏宜兴地区平均风险人群中大肠肿瘤和大肠进展期肿瘤的发生情况和解剖部位分布情况。[方法]采用横断面研究设计。以江苏宜兴地区籍平均风险人群为研究对象,进行结肠镜检查。采用χ2检验比较不同性别、不同年龄组大肠肿瘤和大肠进展期肿瘤解剖学部位分布情况。采用Logistic回归分析方法比较不同年龄组大肠肿瘤和大肠进展期肿瘤的发生风险,并分析远端结肠病变对近端结肠病变的预测作用。[结果]共纳入905例合格研究对象,大肠肿瘤和进展期肿瘤的发生率分别为34.5%和5.3%。远端结肠发生肿瘤和进展期肿瘤的比例均高于近端结肠。男性发生大肠肿瘤和进展期肿瘤的风险明显高于女性(P<0.01)。随着年龄增长,大肠肿瘤和进展期肿瘤的发生风险均明显增加(P<0.01),远端结肠肿瘤和进展期肿瘤发生率增加的幅度均高于近端结肠。年龄增长与大肠肿瘤发生风险增加的关系主要表现在女性人群。在控制年龄、性别的影响后,远端结肠肿瘤患者发生近端结肠肿瘤的风险仍然明显高于远端结肠无病变者(OR=1.94,95%CI:1.30~2.88,P=0.001),说明远端结肠肿瘤病变对于近端结肠肿瘤具有预测作用;远端结肠进展期肿瘤病变对于近端结肠进展期肿瘤的预测作用不明显。[结论]本研究具有较强的科学性和较高的可信度。研究结果为制定该人群的大肠癌筛查策略提供了科学依据。
[Objective] To investigate the incidence and anatomic distribution of colorectal tumor and advanced colorectal cancer in the average risk population in Yixing, Jiangsu Province. [Methods] Designing with cross-sectional study. Taking the average risk population in Yixing, Jiangsu Province as the research object, colonoscopy was performed. The χ2 test was used to compare the distribution of tumor anatomical parts of colorectal tumors and large intestine in different gender and age groups. Logistic regression analysis was used to compare the risk of colorectal tumor and advanced colorectal cancer in different age groups and to predict the effect of distal colonic lesions on proximal colonic lesions. [Results] A total of 905 eligible subjects were enrolled. The incidence of colorectal tumors and advanced tumors were 34.5% and 5.3%, respectively. The proportion of tumors in the distal colon and those in the advanced tumors was higher than in the proximal colon. The risk of developing colorectal tumors and advanced tumors was significantly higher in men than in women (P <0.01). With the increase of age, the risk of colorectal tumor and advanced tumor were significantly increased (P <0.01), and the incidence of distal colorectal cancer and advanced tumor was higher than that of proximal colon. The relationship between the growth of age and the risk of colorectal cancer is mainly manifested in the female population. The risk of proximal colon tumors in patients with distal colon tumors was still significantly higher than those without distal colon after controlling for age and gender (OR = 1.94, 95% CI: 1.30-2.88, P = 0.001) Distal colon cancer lesions have predictive value for proximal colon tumors; distal colon progression tumor lesions have no obvious predictive value for proximal colon advanced tumors. [Conclusion] This study has strong scientific and high credibility. The results provide a scientific basis for the development of colorectal cancer screening strategies in this population.