APCS评分系统与问卷调查在体检人群结直肠癌机会性筛查中效果的比较
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摘要
目的评估亚太结直肠癌筛查评分系统(APCS)和结直肠肿瘤高危因素问卷调查(HRFQ)在体检人群结直肠癌机会性筛查中的效果。方法选取2017年6月~2018年2月在中国航天科工集团七三一医院体检中心进行健康体检并接受结肠镜检查的人群294例,年龄57.28±9.85岁。采用APCS评分与HRFQ进行筛查;进行结肠镜检查一并记录结肠镜检查及病理结果。通过对比两种初筛工具筛查结直肠肿瘤的阳性预测值以及阴性预测值,评估两种初筛工具在体检人群结直肠癌机会性筛查中的效果。结果结肠镜检查共检出结直肠肿瘤50例。两种不同筛查方法 APCS评分(高危+中危)对结直肠肿瘤的阳性预测值(20.35%vs 15.07%)及阴性预测值(95.24%vs 82.35%),均明显高于HRFQ,差异有统计学意义(P<0.05)。结论在体检人群结直肠癌机会性筛查中,作为初筛工具,APCS评分与HRFQ相比,能提高结直肠肿瘤的阳性预测值与阴性预测值,适合大范围推广。
Objective To evaluate the effect of Asia-Pacific Colorectal Screening(APCS) scoring system and a high risk factors questionnaire(HRFQ) in physical examination population opportunistic screening for colorectal cancer. Methods Patients who had the annual physical examination in No. 731 Hospital of China Aerospace Science & Industry Corporation(CASIC)from June2017 to February 2018 were enrolled into this study. Before colonoscopy,the APCS score and HRFQ were used to screen the subjects.Records of colonoscopy and pathological results were recorded. The effect of APCS scoring system and HRFQ was evaluated in physical examination population opportunistic screening for colorectal cancer by comparing the positive predictive value(PPV) and the negative predictive vale(NPV) of colorectal neoplasms. Results A total of 294 eligible patients were enrolled,with an average age of 57.28 + 9.85 years,and 50 cases of colorectal neoplasms were detected.For APCS scores(moderate risk and high risk) and HRFQ,the PPV were 20.35% and 15.07%(P < 0.05) and the NPV were 95.24% and 82.35%(P < 0.05),respectively. The PPV and the NPV were statistical significance. Conclusion As a primary screening tool,the APCS scoring system,compared with HRFQ,can improve the PPV and the NPV of colorectal neoplasms in physical examination population opportunistic screening for colorectal cancer,which is suitable for a wide range of promotion.
Objective To evaluate the effect of Asia-Pacific Colorectal Screening(APCS) scoring system and a high risk factors questionnaire(HRFQ) in physical examination population opportunistic screening for colorectal cancer. Methods Patients who had the annual physical examination in No. 731 Hospital of China Aerospace Science & Industry Corporation(CASIC)from June2017 to February 2018 were enrolled into this study. Before colonoscopy,the APCS score and HRFQ were used to screen the subjects.Records of colonoscopy and pathological results were recorded. The effect of APCS scoring system and HRFQ was evaluated in physical examination population opportunistic screening for colorectal cancer by comparing the positive predictive value(PPV) and the negative predictive vale(NPV) of colorectal neoplasms. Results A total of 294 eligible patients were enrolled,with an average age of 57.28 + 9.85 years,and 50 cases of colorectal neoplasms were detected.For APCS scores(moderate risk and high risk) and HRFQ,the PPV were 20.35% and 15.07%(P < 0.05) and the NPV were 95.24% and 82.35%(P < 0.05),respectively. The PPV and the NPV were statistical significance. Conclusion As a primary screening tool,the APCS scoring system,compared with HRFQ,can improve the PPV and the NPV of colorectal neoplasms in physical examination population opportunistic screening for colorectal cancer,which is suitable for a wide range of promotion.
引文
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[10]李其龙,俞玲玲,薛峰,等.我国现行大肠癌优化序贯筛查方案评价[J].中华预防医学杂志,2014,48(11):995-1000.
[11]Bai Y,Xu C,Zou DW,et al.Diagnostic accuracy of features predicting lower gastrointestinal malignancy:a colonoscopy database review of 10 603 Chinese patients[J].Colorectal Dis,2011,13(6):658-662.
[12]Nguyen SP,Bent S,Chen YH,et al.Gender as a risk factor for advanced neoplasia and colorectal cancer:a systematic review and meta-analysis.[J].Clin Gastroenterol Hepatol,2009,7(6):676-681.
[13]陈琼,刘志才,程兰平,等.2003~2007年中国结直肠癌发病与死亡分析[J].中国肿瘤,2012,21(3):179-182.
[2]田正凤,陈洪,翟爱军,等.北京云岗地区体检人群结直肠癌机会性筛查结果分析[J].首都医科大学学报,2016,37(1):34-37.
[3]Sung JJ,Ng SC,Chan FK,et al.An updated Asia pacific consensus recommendations on colorectal cancer screening[J].Gut,2015,64(1):121-132.
[4]Yeoh KG,Ho KY,Chiu HM,et al.The Asia-Pacific Colorectal Screening score:a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects[J].Gut,2011,60(9):1236-1241.
[5]卫生部疾病预防控制局,癌症早诊早治项目专家委员会.癌症早诊早治项目技术方案[M].北京:人民卫生出版社,2011:150-189.
[6]World Health Organization.WHO Classification of tumors.pathology and genetics of tumors of the digestive system[M].Lyon:IARC Press,2000:105-118.
[7]中华医学会消化内镜学分会,中国抗癌协会肿瘤内镜学专业委员会.中国早期结直肠癌筛查及内镜诊治指南(2014年,北京)[J].中华消化内镜杂志,2015,32(6):341-360.
[8]Corley DA,Jensen CD,Marks AR,et al.Adenoma detection rate and risk of colorectal cancer and death[J].N Engl J Med,2014,370(14):1298-306.
[9]翟爱军,陈洪,王贵齐,等.三种结直肠癌筛查方法比较研究[J].中国全科医学,2016,19(2):170-173.
[10]李其龙,俞玲玲,薛峰,等.我国现行大肠癌优化序贯筛查方案评价[J].中华预防医学杂志,2014,48(11):995-1000.
[11]Bai Y,Xu C,Zou DW,et al.Diagnostic accuracy of features predicting lower gastrointestinal malignancy:a colonoscopy database review of 10 603 Chinese patients[J].Colorectal Dis,2011,13(6):658-662.
[12]Nguyen SP,Bent S,Chen YH,et al.Gender as a risk factor for advanced neoplasia and colorectal cancer:a systematic review and meta-analysis.[J].Clin Gastroenterol Hepatol,2009,7(6):676-681.
[13]陈琼,刘志才,程兰平,等.2003~2007年中国结直肠癌发病与死亡分析[J].中国肿瘤,2012,21(3):179-182.