近端锯齿状息肉检出的单中心回顾性研究
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1.香港大学深圳医院消化内科;2.南京鼓楼医院消化内科

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深圳市临床研究项目基金(SZLY2017029);深圳市卫生系统科研项目(SZFZ2018008)


Detection of proximal serrated polyps: a single-center retrospective analysis
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Department of Gastroenterology, The University of Hong Kong-Shenzhen Hospital

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Shenzhen Clinical Research Project Fund(SZLY2017029);Shenzhen Health System Research Project(SZFZ2018008)

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    摘要:

    目的 探讨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,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)。内镜医师是近端锯齿状息肉检出的显著危险因素(P<0.01),与检出率最高的医师相比,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。

    Abstract:

    Objective To investigate the prevalence and endoscope detection rate of proximal serrated polyps and to screen the risk factors. Methods The 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 of ADR and PSDR was estimated by Pearson correlation coefficients. Multivariate logistic regression was used to analyze PSDR among endoscopists. Results For 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 to endoscopist with the highest detection rate, odds ratio of other endoscopists ranged from 0.16 (95%CI: 0.06-0.40) to 0.83 (95%CI: 0.53-1.32). Conclusion Proximal serrated polyp has a high detection rate by endoscope 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.

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李青云,肖鹏,凌亭生,等.近端锯齿状息肉检出的单中心回顾性研究[J].中华消化内镜杂志,2019,36(2).

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  • 收稿日期:2018-02-12
  • 最后修改日期:2019-01-04
  • 录用日期:2018-08-27
  • 在线发布日期: 2019-02-13
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