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目的研究大肠癌先证患者的一级亲属的电子肠镜和粪便潜血试验(faecal occultblood testing,FOBT)筛查的临床意义。方法前瞻性分析大肠癌先证患者的一级亲属186例的电子肠镜和 FOBT 的筛查结果。FOBT 应用试纸免疫法和氨基比林化学法。结果在186例亲属的肠镜检查中阳性病变检出率高达80.1%,其中癌前病变占41.1%,恶性疾病占23.6%。而 FOBT 的检出率只有22.3%,明显低于肠镜的检出率(P<0.001)。大肠息肉、息肉癌变和大肠癌在一级亲属的检出率分别为56.5%、6.5%和17.2%,在对照组分别为25.7%、0.5%和6.5%,两组比较,P 均小于0.001。本组小于40岁的患者占阳性病变的20.1%和恶性病变的17.1%。肠镜检查检出 Dukes A 期大肠癌18例,占56.3%,B 期12例,占37.5%,C 期2例,占6.3%,D 期0例。所有大肠癌患者均可进行根治性手术切除。结论在大肠癌先证患者的一级亲属中进行结肠镜筛查明显优于 FOBT,具有较高的检出率,并可预防大肠癌和早期诊断大肠癌和提高根治手术率。
Objective To study the clinical significance of screening colonoscopy and faecal occult blood testing (FOBT) in first degree relatives of patients with colorectal cancer. Methods We prospectively analyzed 186 cases of colonoscopy and FOBT screening of first-degree relatives of patients with colorectal cancer. FOBT application strip immunoassay and aminopyrine chemistry. Results The positive rate of positive lesions was 80.1% in colonoscopy of 186 relatives, of which, precancerous lesions accounted for 41.1% and malignant diseases accounted for 23.6%. The FOBT detection rate was only 22.3%, significantly lower than the colonoscopy detection rate (P <0.001). The detection rates of colorectal polyps, polyposis carcinomas and colorectal cancer in first-degree relatives were 56.5%, 6.5% and 17.2% in the control group and 25.7%, 0.5% and 6.5% in the control group respectively. The group of patients less than 40 years of age accounted for 20.1% of positive lesions and 17.1% of malignant lesions. Colonoscopy Dukes A colorectal cancer in 18 cases, accounting for 56.3%, B in 12 cases, accounting for 37.5%, C 2 cases, accounting for 6.3%, D 0 cases. All patients with colorectal cancer can be a radical surgical resection. Conclusion Colonoscopy is superior to FOBT in first-degree relatives of patients with colorectal cancer, which has a higher detection rate and can prevent colorectal cancer and early diagnosis of colorectal cancer and improve the rate of radical surgery.