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目的探讨乙状结肠镜检查对大肠肿瘤的漏诊情况。方法总结分析惠州市中心人民医院(2006年～2008年)和广州南方医院(2004年～2006年)行结肠镜检查发现大肠肿瘤者、年龄为50～79岁的连续性资料。结果72.0%近端大肠肿瘤患者在其远端大肠未发现相应肿瘤性病变,其中男性该比例为66.5%,女性为82.3%;50～59岁、60～69岁、70～79岁年龄段的比例分别为74.7%、72.0%、67.9%。远近端大肠高级别癌灶比例分别为5.1%和15.8%(P<0.01)。结论近端大肠癌的恶性程度较远端大肠癌高;如果乙状结肠镜发现远端大肠肿瘤才进行全结肠镜检查,将导致72.0%近端大肠肿瘤漏诊。
Objective To investigate the misdiagnosis of sigmoidoscopy for colorectal tumors. Methods The data of colorectal cancer patients who were diagnosed colorectal cancer with colonoscopy at the Central Hospital of Huizhou (2006 ~ 2008) and Guangzhou Nanfang Hospital (2004 ~ 2006) were summarized and analyzed. The data were from 50 to 79 years of age. Results 72.0% of patients with proximal colorectal tumors had no tumor lesions in their distal colon. The prevalence rate was 66.5% for males and 82.3% for females. In the age groups of 50-59, 60-69 and 70-79 The proportions were 74.7%, 72.0% and 67.9% respectively. The proportion of high-grade and high-grade cancers in distal and proximal end were 5.1% and 15.8%, respectively (P <0.01). Conclusion The malignant degree of proximal colorectal cancer is higher than that of distal colorectal cancer. If colonoscopy is performed on the distal colorectal tumor, sigmoidoscopy will result in missed diagnosis of proximal colorectal cancer by 72.0%.