Clinical features of colorectal cancer before diagnosis: a population-based case-control study.
Clinical features of colorectal cancer before diagnosis: a population-based case-control study.
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诊断前结直肠癌的临床特征：一项基于人群的病例对照研究。
DOI：
10.1038/sj.bjc.6602714
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发表时间：
2005-08-22
影响因子：
8.8
通讯作者：
Peters, TJ
中科院分区：
文献类型：
--
作者：
Hamilton, W;Round, A;Sharp, D;Peters, TJ
大多数结直肠癌是在症状出现后才被诊断出来的。然而，由特定症状引起的结直肠癌风险在很大程度上是未知的，特别是在初级保健等未选择的人群中。这是一项基于人群的病例对照研究，在英国德文郡埃克塞特的所有21个全科诊所进行，旨在确定和量化结直肠癌的诊断前特征。总共研究了349名年龄在40岁或以上的结直肠癌患者和1744名对照患者，他们的年龄、性别和一般情况相匹配。诊断前2年的全部医疗记录使用国际初级保健分类-2进行编码。我们使用多变量条件逻辑回归计算了与癌症独立相关的变量的比值比，然后计算了这些变量的正预测值，无论是单独的还是组合的。在诊断前，总共有10个特征与结直肠癌相关。阳性预测值（95%置信区间）为直肠出血2.4% (1.9,3.2)；体重减轻1.2% (0.91,1.6)；腹痛1.1% (0.86,1.3)；腹泻0.94% (0.73,1.1)；便秘0.42% (0.34,0.52)；直肠检查异常4.0% (2.4,7.4)；腹部压痛1.1% (0.77,1.5)；血红蛋白<10.0 g dl - 1 2.3% (1.6, 3.1)；粪便隐血阳性7.1% (5.1,10)；血糖bbb10 mmol l−1 0.78%(0.51,1.1)：均P<0.001。使用单个或多个症状、体征或测试结果的预测值，可能会对结直肠癌进行早期诊断。
Most colorectal cancers are diagnosed after the onset of symptoms. However, the risk of colorectal cancer posed by particular symptoms is largely unknown, especially in unselected populations like primary care. This was a population-based case–control study in all 21 general practices in Exeter, Devon, UK, aiming to identify and quantify the prediagnostic features of colorectal cancer. In total, 349 patients with colorectal cancer, aged 40 years or more, and 1744 controls, matched by age, sex and general practice, were studied. The full medical record for 2 years before diagnosis was coded using the International Classification of Primary Care-2. We calculated odds ratios for variables independently associated with cancer, using multivariable conditional logistic regressions, and then calculated the positive predictive values of these variables, both individually and in combination. In total, 10 features were associated with colorectal cancer before diagnosis. The positive predictive values (95% confidence interval) of these were rectal bleeding 2.4% (1.9, 3.2); weight loss 1.2% (0.91, 1.6); abdominal pain 1.1% (0.86, 1.3); diarrhoea 0.94% (0.73, 1.1); constipation 0.42% (0.34, 0.52); abnormal rectal examination 4.0% (2.4, 7.4); abdominal tenderness 1.1% (0.77, 1.5); haemoglobin <10.0 g dl−1 2.3% (1.6, 3.1); positive faecal occult bloods 7.1% (5.1, 10); blood glucose>10 mmol l−1 0.78% (0.51, 1.1): all P<0.001. Earlier diagnosis of colorectal cancer may be possible using the predictive values for single or multiple symptoms, physical signs or test results.
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DOI：
10.1111/j.1445-2197.1991.tb00190.x
发表时间：
1991-02-01
期刊：
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY
影响因子：
--
作者：
KYLE, SM;ISBISTER, WH;YEONG, ML
通讯作者：
YEONG, ML
影响因子：
168.9
作者：
Selvachandran, SN;Hodder, RJ;Cade, D
通讯作者：
Cade, D
影响因子：
105.7
作者：
Steele, RJC
通讯作者：
Steele, RJC
影响因子：
6.3
作者：
MACARTHUR, C;SMITH, A
通讯作者：
SMITH, A
影响因子：
5
作者：
Coughlin, SS;Calle, EE;Thun, MJ
通讯作者：
Thun, MJ