首页|EARLY DIAGNOSIS FOR COLORECTAL CANCER IN CHINA: A PRESENT STUDY REVIEW

EARLY DIAGNOSIS FOR COLORECTAL CANCER IN CHINA: A PRESENT STUDY REVIEW

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The colorectal cancer is one of the most common of malignant tumors in China。 This paper reviews the present study of early diagnosis of colorectal cancer。 The detective rate for early cancer is 1。7%-26。1%, based on various statistical data with much higher detective rate in endoscopy。 Since early cancer means invasion involves the mucosa or submucosal, the diagnosis only can be made when the invasive depth is identified。 Pathological tissue materials from both surgical operation or endoscopy resection are suitable for early cancer evaluation。 Incidence of polyp malignancy is 1。4%~20。4%。 The various constitutive proportion of polyps may explain the different rate。 Malignant incidence is higher in adenomatous polyps, for villous polyps can reach 21。3%~58。3%。 Type II early stage of colorectal carcinoma is rare reported in China。 It is showed that majority of them were not malignancy, such as most of type IIa were adenoma or hyperplasia, IIb were inflammatory and IIc might be the isolated ulcers。 The occurrence of malignancy of type II is far lower than that of polypoid lesion。 In China, the qualitative diagnosis and classification of neoplasm generally adopted the WHO standard no matter to surgical excision or biopsies。 There is impersonal evaluation between colorectal pre-malignancy and cancer。 The former emphasizes on the dysplasia of nuclei and gland, while the later is marked with cancer invasion。 Diagnosis of early stage colorectal cancer in endoscopy is with much too cautions which made the detective rate much lower。 Mass screening for asymptomatic subjects and follow-up for high risk population are the main way to find the early stage of colorectal cancer in China。 Fecal occult blood test is widely used as primary screening test, galactose oxygenase test of rectal mucus(T antigen), fecal occult albumin test are also used。 The detective rate of colorectal cancer is 24~36。5 per 10~5 mass population。 Although carcinoma associated antigen in blood or stool, microsatellite DNA instability for high risk familial history, molecular biology technology for stool oncogene or antioncogene, telomerase activity and exfoliative cytological examination for tumor marker, none of them is used in mass screening by now。

chinacolorectalcancerearly diagnosisendoscopybiopsymass screening

Zhang Yali、Zhang Zhensu、Wu Baping、Zhou Dianyuan

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Department of Gastroenterology, PLA Institute of digestive diseases, First Medical University of PLA, Guangzhou, 510515, P.R.China

Japan-Sino workshop on endoscopy and gastroenterology

Kobe(JA)

The Second Japan-Sino Workshop on Endoscopy and Gastroenterology: Program and Abstracts, 2nd, May 10, 2001, Kobe, Japan

p.63-70

2001