目的:探讨症状性及无症状人群中结肠直肠肿瘤性疾病的分布规律,以期更好地指导今后的临床及科研工作。方法:收集2013年1月至2014年2月间上海交通大学医学院附属瑞金医院北院就诊的3 509例结肠镜检查人群基本信息,包括性别、年龄、发病时的症状、结肠镜检查结果及相关病理检查结果。将受检者分为症状筛查组(如腹痛、腹泻、黏液便、腹胀等)和无症状筛查组(粪便隐血试验阳性),进行统计学分析以期找出其中的相同及差异。结果:3 509例结肠镜受检者的平均年龄为(55±13)岁,按症状分为症状筛查组和无症状筛查组(639例)。3 509例受检者的结肠直肠息肉检出率为34.4%,结肠直肠癌检出率为2.6%。男女性别间的病灶检出率无差异,而60~69岁受检者的恶性肿瘤占所有检出肿瘤构成比为44.0%。所有结肠直肠癌以远端结肠(直肠、乙状结肠)为主(66.7%);结肠直肠息肉与结肠直肠癌并存患者数占结肠直肠癌总数的36.6%。症状筛查组的结肠直肠息肉检出率为33.0%,结肠直肠癌检出率为2.5%;无症状筛查组的结肠直肠息肉检出率为41.2%,结肠直肠癌检出率为3.2%。2组间的结肠直肠息肉检出率差异有统计学意义,而结肠直肠癌检出率差异无统计学意义。结论:上海市嘉定地区接受结肠镜检查人群的结肠直肠息肉检出率较高,针对粪便隐血筛查阳性的无症状人群进行结肠镜检查,对于早期发现结肠直肠肿瘤有重要意义。 Objective: To investigate the distribution of colorectal neoplasms in symptomatic and asymptomatic groups with a view to better guiding future clinical and scientific research. Methods: The data of 3 509 colonoscopy patients attending the north hospital of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2013 to February 2014 were collected, including sex, age, onset symptoms, colonoscopy results and Related pathological findings. The subjects were divided into symptom screening group (such as abdominal pain, diarrhea, mucus, bloating, etc.) and asymptomatic screening group (stool occult blood test positive), statistical analysis to find out the same and differences. Results: The average age of 3 509 colonoscopy patients was (55 ± 13) years old. According to the symptoms, they were divided into symptoms screening group and asymptomatic screening group (639 cases). The detection rate of colorectal polyps in 3 509 subjects was 34.4% and the colorectal cancer was 2.6%. There was no difference in the detection rate of lesions between men and women, while the percentage of malignant tumors in the 60- to 69-year-old subjects accounted for 44.0% of the total detected tumors. All colorectal cancers were mainly distal colon (rectum and sigmoid colon) (66.7%). Colorectal polyps and colorectal carcinoma coexisted 36.6% of all colorectal cancers. The detection rate of colorectal polyps was 33.0% in symptom screening group and 2.5% in colorectal cancer. The detection rate of colorectal polyps in asymptomatic screening group was 41.2% and that in colorectal cancer was 3.2% . The detection rate of colorectal polyp between the two groups had statistical significance, but the detection rate of colorectal cancer had no statistical significance. CONCLUSION: The detection rate of colorectal polyps in colonoscopy patients in Jiading district of Shanghai is high, and colonoscopy for asymptomatic positive stool occult blood screening patients is of great significance for the early detection of colorectal tumors.