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背景:在我国有无必要开展大肠癌普查仍存在一定争议。目的:比较、分析医院就诊人群与普查人群中大肠癌患者临床资料的异同,探讨普查在大肠癌早期诊断中的作用。方法:就诊组:由协作组各成员医院按统一设计的调查表,前瞻性地登记2002年4月1日～2003年3月31日到医院就诊,并接受结肠镜检查的大肠癌患者的全部临床资料。普查组:采用“序贯粪便隐血筛检技术”,于2001年3～6月对北京地区约2万名35岁以上的自然人群进行大肠癌普查。两组大肠癌患者的诊断均经术后病理检查证实。结果:就诊组和普查组患者中,≥50岁者分别占81.9%和83.3%。就诊组DukesA、B期患者占41.1%,普查组占91.7%(P<0.001)。普查人群中存在大肠癌高危因素者的大肠癌检出率为0.28%,无高危因素者的检出率为0.05%(P<0.001)。就诊组中,内镜表现为隆起型病变者44.7%是DukesA、B期患者,溃疡型病变者仅10.0%是DukesA、B期患者(P<0.001);DukesA、B期患者的粪便隐血试验阳性率为78.5%,C、D期患者为81.9%(P>0.05),提示粪便隐血试验阳性率与大肠癌分期无关;DukesC、D期患者的血清CEA阳性率显著高于A、B期患者(P=0.019);高、中分化癌中DukesA、B期患者占51.8%,低分化癌中DukesA、B期患者仅占26.5%(P<0.001)。结论:近年北京地区的大肠癌发病率较以前明显上升
Background: There is still some controversy about the necessity of carrying out the general survey of colorectal cancer in our country. OBJECTIVE: To compare and analyze the similarities and differences of clinical data of patients with colorectal cancer in hospitals and censuses, and to explore the role of censuses in the early diagnosis of colorectal cancer. Methods: The visiting group: all the collaborating group of members of the hospital according to a unified design of the questionnaire, prospective registration April 1, 2002 ~ March 31, 2003 to the hospital and colonoscopy in patients with colorectal cancer all clinical information. Census group: “Sequential fecal occult blood screening technology”, from March to June 2001 in Beijing about 20,000 people over the age of 35 for colorectal cancer screening. Two groups of patients with colorectal cancer were confirmed by pathological examination. Results: In the treatment group and the census group, those over 50 years old accounted for 81.9% and 83.3% respectively. The treatment group DukesA, B patients accounted for 41.1%, the survey group accounted for 91.7% (P <0.001). The prevalence of colorectal cancer was 0.28% in those with high risk of colorectal cancer in the census population, and 0.05% (P <0.001) in those without high risk factors. In the treatment group, 44.7% of patients with Dukes A and B lesions showed endoscopic Dukes A and B disease, and only 10.0% of Dukes A and B patients with Dukes A and B disease (P <0.001). Dukes A and B patients had positive fecal occult blood test (P> 0.05). The positive rate of fecal occult blood test was not related to the staging of colorectal cancer. The positive rate of CEA in DukesC and D patients was significantly higher than that in patients with A and B P = 0.019). DukesA and B patients accounted for 51.8% in high and moderately differentiated cancers and only 26.5% in patients with poorly differentiated cancers DukesA and B (P <0.001). Conclusion: In recent years, the incidence of colorectal cancer in Beijing increased significantly than before