| 郭兰伟,郑黎阳,陈 琼,等.亚太结直肠癌风险评分系统在我国北方无症状人群筛查中的应用[J].中国肿瘤,2022,31(8):649-654. |
| 亚太结直肠癌风险评分系统在我国北方无症状人群筛查中的应用 |
| Application of Asia-Pacific Colorectal Screening Score in Screening Asymptomatic Population in Northern China |
| 投稿时间：2022-05-06 |
| DOI：10.11735/j.issn.1004-0242.2022.08.A005 |
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| 中文关键词: 亚太结直肠癌筛查评分系统 高危人群 筛查 |
| 英文关键词:Asia-Pacific Colorectal Screening Score high risk population screening |
| 基金项目:国家重大公共卫生服务专项-城市癌症早诊早治项目 |
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| 中文摘要: |
| 摘 要： ［目的］ 评价亚太结直肠癌筛查评分系统（APCS）在我国北方无症状人群筛查中的应用价值。［方法］ 采取整群抽样的方法，选取河南省40~74岁城市户籍无症状人群进行癌症危险因素调查和结肠镜检查，应用APCS计算每位研究对象患进展期肿瘤的危险分值，绘制受试者工作特征（ROC）曲线，并计算曲线下面积（AUC） 和95%可信区间（95%CI)，并采用Logistic回归分析计算不同危险分层中患结直肠进展期肿瘤的OR值及95%CI。［结果］ 共纳入无症状人群7 454例，接受结肠镜检查前评分，平均年龄（55.01±7.91）岁，进展期肿瘤检出率为1.50%。APCS分值范围为0~7分，预测的一致性好（P=0.886），区分能力一般（AUC为0.628，95%CI：0.579~0.678），但优于仅基于年龄变量的预测模型。以低风险组（0~1分）为对照组，中风险组（2~3分）和高风险组（4~7分）发生进展期肿瘤的风险分别为低风险组的1.97倍（95%CI：0.83~4.65）和4.07倍（95%CI：1.76~9.42）。［结论］ 基于年龄、性别、一级亲属结直肠癌家族史和吸烟构建的APCS是确定中国北方无症状人群进展期肿瘤风险的有用工具。 |
| 英文摘要: |
| Abstract： ［Purpose］ To evaluate the application value of Asia-Pacific Colorectal Screening Score(APCS) in asymptomatic population screening in northern China. ［Methods］ A cluster sampling method was used to select the asymptomatic residents of 40~74 years old in Henan Province to investigate the risk factors and colonoscopy. A receiver operating characteristic(ROC) analysis was performed to calculate the area under the curve(AUC) and 95% confidence interval(95%CI) according to the APCS scoring system for each subject. Logistic regression analysis was used to calculate the odds ratio(OR) and 95% CI of advanced neoplasm in groups of different risks collected. ［Results］ Totally， there were 7 454 subjects with mean age of (55.01±7.91) years old， and the detection rate of advanced neoplasm was 1.50%. The APCS scores ranged from 0 to 7 and the predictions were consistent(P=0.886). The distinguishing ability was moderate(AUC=0.628， 95%CI：0.579~0.678)， but better than the prediction model based on age only. Taking the average risk group(0~1 points) as control， the risk of developing advanced neoplasm in the moderate risk group(2~3 points) and the high risk group(4~7 points) were 1.97-fold(95%CI：0.83~4.65) and 4.07-fold(95%CI：1.76~9.42) respectively. ［Conclusion］ The APCS scoring system based on age， sex， family history of colorectal cancer in a first-degree relatives and smoking is a useful tool to determine the risk of advanced neoplasm in asymptomatic people in northern China. |
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