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【medical-news】CT结肠成像术：筛查肿瘤的合适方法
Background Advanced neoplasia represents the primary target for colorectal-cancer screening and prevention. We compared the diagnostic yield from parallel computed tomographic colonography (CTC) and optical colonoscopy (OC) screening programs.
Methods We compared primary CTC screening in 3120 consecutive adults (mean [±SD] age, 57.0±7.2 years) with primary OC screening in 3163 consecutive adults (mean age, 58.1±7.8 years). The main outcome measures included the detection of advanced neoplasia (advanced adenomas and carcinomas) and the total number of harvested polyps. Referral for polypectomy during OC was offered for all CTC-detected polyps of at least 6 mm in size. Patients with one or two small polyps (6 to 9 mm) also were offered the option of CTC surveillance. During primary OC, nearly all detected polyps were removed, regardless of size, according to established practice guidelines.
Results During CTC and OC screening, 123 and 121 advanced neoplasms were found, including 14 and 4 invasive cancers, respectively. The referral rate for OC in the primary CTC screening group was 7.9% (246 of 3120 patients). Advanced neoplasia was confirmed in 100 of the 3120 patients in the CTC group (3.2%) and in 107 of the 3163 patients in the OC group (3.4%), not including 158 patients with 193 unresected CTC-detected polyps of 6 to 9 mm who were undergoing surveillance. The total numbers of polyps removed in the CTC and OC groups were 561 and 2434, respectively. There were seven colonic perforations in the OC group and none in the CTC group.
Conclusions Primary CTC and OC screening strategies resulted in similar detection rates for advanced neoplasia, although the numbers of polypectomies and complications were considerably smaller in the CTC group. These findings support the use of CTC as a primary screening test before therapeutic OC.
http://content.nejm.org/cgi/content/short/357/14/1403 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 初译：
CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia
CT结肠成像术：筛查肿瘤的合适方法
Background Advanced neoplasia represents the primary target for colorectal-cancer screening and prevention. We compared the diagnostic yield from parallel computed tomographic colonography (CTC) and optical colonoscopy (OC) screening programs.
背景：结肠癌筛查和预防主要的目标是阻滞晚期肿瘤形成。我们对CT结肠成像（CTC）以及结肠镜检筛查（OC）进行诊断对比。
Methods We compared primary CTC screening in 3120 consecutive adults (mean [±SD] age, 57.0±7.2 years) with primary OC screening in 3163 consecutive adults (mean age, 58.1±7.8 years). The main outcome measures included the detection of advanced neoplasia (advanced adenomas and carcinomas) and the total number of harvested polyps. Referral for polypectomy during OC was offered for all CTC-detected polyps of at least 6 mm in size. Patients with one or two small polyps (6 to 9 mm) also were offered the option of CTC surveillance. During primary OC, nearly all detected polyps were removed, regardless of size, according to established practice guidelines.
方法：我们对3120例成人患者（年龄平均值加标准差：57.0±7.2岁）进行主要CTC检查以及3163例成人患者（平均年龄：58.1±7.8岁）进行主要OC检查对比。评估的主要结果包括检测晚期肿瘤（晚期腺瘤和癌）以及息肉数目。在OC 筛查中息肉切除的参考指标为CTC检测息肉至少为6mm体积。有1或2个小息肉（6至9mm）患者也进行CTC监测。在初期的OC筛查中，据实践指南，无论体积几乎所有检测的息肉都进行切除。
Results During CTC and OC screening, 123 and 121 advanced neoplasms were found, including 14 and 4 invasive cancers, respectively. The referral rate for OC in the primary CTC screening group was 7.9% (246 of 3120 patients). Advanced neoplasia was confirmed in 100 of the 3120 patients in the CTC group (3.2%) and in 107 of the 3163 patients in the OC group (3.4%), not including 158 patients with 193 unresected CTC-detected polyps of 6 to 9 mm who were undergoing surveillance. The total numbers of polyps removed in the CTC and OC groups were 561 and 2434, respectively. There were seven colonic perforations in the OC group and none in the CTC group.
结果：在用CTC和OC筛查中，分别发现123和121例晚期肿瘤，包括14例和4例浸润性癌症。在主要CTC筛查组中对于OC组的参照率为7.9％（3120例患者中有246例患者）。在CTC组3120例患者中证实晚期肿瘤患者有100例(3.2%)，而在3163例OC组中有107例(3.4%)，不包括158例患者中193个用CTC检测不能分辨的6 至9mm需要进行监测的息肉。在CTC组和OC组中切除息肉的数目分别为561和2434例。在OC组中有7例结肠穿孔，而在CTC组中结肠穿孔无1例出现。
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作者:admin@医学,生命科学 2011-06-28 05:45
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