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背景和目的:“两步法”大肠肿瘤普查的假阳性和假阴性率较高,“一步法”的依从性又较差。该研究比较这两种方法在高危人群普查中的效/价比及其适用范围。 方法:A组:419名50岁以上人群参加盲法普查,同步进行肠镜和粪便筛检试验(OB、MA和SC)B组:2500名50岁以上人群先行粪便隐血(Hemoccult Sensa)检查,阳性者进行肠镜检查。 结果:A组检出腺瘤43例。“一步法”的腺瘤检出率10.34％,各种“两步法”方案的腺瘤检出率仅为0.24％～1.20％。“一步法”每检出1例腺瘤花费482.72元,各“两步法”方案为616～2506元;B组检出腺瘤18例,早期大肠癌1例,肿瘤检出率0.94％,每例花费627.53元。 结论:高危人群的大肠肿瘤普查方法中以“一步法”的效/价最佳。“两步法”各方案中OB、MA互补可望有较好应用前景,适用于一般人群普查。
BACKGROUND AND PURPOSE: The rate of false positives and false negatives in the “two-step method” colorectal neoplasms survey is relatively high, and “one-step method” compliance is poor. The study compares the efficacy/price ratios and the scope of application of these two methods in the screening of high-risk individuals. METHODS: Group A: 419 people over the age of 50 participated in a blinded census, simultaneous colonoscopy and fecal screening tests (OB, MA, and SC) were performed in Group B: 2,500 people over the age of 50 were tested for Hemoccult Sensa. Positive colonoscopy. Results: 43 cases of adenoma were detected in group A. The detection rate of adenomas in the “one-step method” was 10.34%, and the detection rate of adenomas in various “two-step method” protocols was only 0.24% to 1.20%. “One-step method” for each case of adenoma detected costs 482.72 yuan, each “two-step” program for 616 ~ 2506 yuan; B group detected adenoma in 18 cases, 1 case of early colorectal cancer, tumor detection rate of 0.94%, Each case costs 627.53 yuan. Conclusion: The efficacy/price of the “one-step method” is the best in the screening of colorectal tumors in high-risk groups. The complementarity of OB and MA in the “two-step method” scheme is expected to have a good application prospect, and it is applicable to general population screening.