摘要
目的探讨结直肠近端锯齿状息肉的检出情况并筛选其危险因素。方法纳入2016年9月至2017年9月香港大学深圳医院内镜中心22位医师完成的9 010例结肠镜检查病例资料,计算腺瘤检出率(ADR)和近端锯齿状息肉检出率(PSDR),并使用Pearson相关系数评估两者的相关性,利用logistic回归分析对比不同医师的PSDR。结果22位医师的全部受检者平均ADR为30.07%(20.00%~40.78%),PSDR为4.70%(1.52%~9.28%),男性PSDR为女性的1.38倍(OR=1.38,95%CI:1.13~1.69,P<0.01)。≥50岁受检者3 560例(39.51%),平均ADR为45.01%(28.99%~57.78%),PSDR为6.08%(2.07%~10.56%)。在≥50岁受检者中,ADR与PSDR存在中等相关性(r=0.48,P=0.02),男性PSDR为女性的1.36倍(OR=1.36,95%CI:1.04~1.80,P=0.03)。不同内镜医师是近端锯齿状息肉检出的独立危险因素(P<0.01),与PSDR最高的医师相比,其他医师PSDR的OR值范围为0.16(95%CI:0.06~0.40,P<0.01)到0.83(95%CI:0.53~1.32,P=0.44)。结论近端锯齿状息肉在男性以及50岁以上人群中更为多见,检出率与内镜医师显著相关,不同医师的检出率差异巨大,结肠镜检查存在漏诊锯齿状息肉的风险。
ObjectiveTo investigate the prevalence and endoscopic detection rate of proximal serrated polyps and to screen the risk factors. MethodsThe data of 9 010 colonoscopies performed by 22 endoscopists between September 2016 and September 2017 were reviewed. The adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSDR) were calculated, and the correlation between ADR and PSDR was estimated by Pearson correlation coefficients. Multivariate logistic regression was used to analyze PSDR among endoscopists. ResultsFor all subjects, the mean ADR was 30.07%(ranged from 20.00% to 40.78%) and mean PSDR was 4.70%(ranged from 1.52% to 9.28%). PSDR of males was 1.38 times of that of females (OR=1.38, 95%CI: 1.13-1.69, P<0.01). For 3 560 cases (39.51%) of 50 years and older subjects, the mean ADR was 45.01%(28.99%-57.78%) and mean PSDR was 6.08%(2.07%-10.56%). PSDR was moderately correlated with ADR (r=0.48, P=0.02). PSDR of males was 1.36 times of that of females (OR=1.36, 95%CI: 1.04-1.80, P=0.03). Endoscopist was a significant risk factor for detection of proximal serrated polyps (P<0.01). Compared with endoscopist with the highest PSDR, odds ratio of other endoscopists ranged from 0.16 (95%CI: 0.06-0.40, P<0.01) to 0.83 (95%CI: 0.53-1.32, P=0.44). ConclusionProximal serrated polyps are more common in males, who are over 50 years old. The PSDR is highly variable and dependent on endoscopists. It is possible that a certain proportion of proximal serrated polyps are missed during colonoscopy.
作者
李青云
肖鹏
凌亭生
孙洋洋
罗丽君
梁蓉
邓子杰
司徒伟基
Li Qingyun;Xiao Peng;Ling Tingsheng;Sun Yangyang;Luo Lijun;Liang Rong;Deng Zijie;Seto Waikay(Department of Gastroenterology, the University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China;Department of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing 210008, China)
出处
《中华消化内镜杂志》
CSCD
北大核心
2019年第2期86-90,共5页
Chinese Journal of Digestive Endoscopy
基金
深圳市临床研究项目基金(SZLY2017029)
深圳市卫生系统科研项目(SZFZ2018008).
关键词
结肠镜检查
腺瘤
锯齿状息肉
近端
检出率
Colonoscopy
Adenoma
Serrated polyps, proximal
Detection rate
