2006, Number 2
PDF size: 114.72 Kb.
ABSTRACTObjective: To assess the diagnostic value of colonoscopy for cancer in patients with suspicion of colon neoplasm.
Setting: Specialty hospital of the National Medical Center “Manuel Ávila Camacho”.
Design: Retrospective, transversal, descriptive.
Statistical analysis: Descriptive statistics, determination of sensitivity, specificity, positive and negative predictive values (PV+ PV-), and positive and negative odds ratio (OR), and multiple regression.
Material and methods: The study period comprised from January 1998 to June 2000. Direct variables analyzed were: diagnosis or not of colon neoplasm by means of colonoscopy, and the secondary variables were age, gender, and symptoms considered as cause for “clinical suspicion” of being a colon neoplasm carrier, these were: abdominal pain, weight loss, alterations in intestinal habits, low intestinal tract hemorrhage, anemia, palpable tumor, positive rectal examination, intestinal occlusion, and fever.
Results: We studied 40 patients with clinical suspicion of colorectal cancer and abnormal signs in the colon by enema study. Colonoscopy was normal in 37 (92.5%) patients. Biopsies were performed in all 40 patients, resulting: 7 benign: 3 (42.8%) unspecific chronic inflammatory processes and 4 (57.2%) normal tissue; 33 malignant: 30 adenocarcinomas (91%), 2 lymphomas (6%), and 1 metastatic carcinoma (3%). Sensitivity was 100%, specificity 42.8% PV+ 89.1%, PV-100%, OR+ 1.74 and OR- 0.
Conclusion: Colonoscopy can discard the presence of malignancy.
Luna-Pérez P, Reyna HA, Rodríguez CDF, Medrano R, González MJ. Cáncer colorrectal. Rev Gastroenterol Mex 1997; 62: 175-83.
Luna-Pérez P, Quinonez G, Benítez-Bribiesca L, Barrientos FJ, de la Torre ALP, Quiñones G, Benítez B. Cáncer colorrectal hereditario sin poliposis. (HNPCC) Rev Gastroenterol Mex 1995; 60: 169-74.
Levin TR. Colorectal cancer screening: new opportunities. Sur Oncol Clin N Am 1999; 8(4): 673-91, vi-vii.
Achiam MP, Bulow S, Rosenberg J. CT-and MR colonography. Scand J Surg 2002; 91: 322-7.
Brady AP, Stevenson GW, Stevenson I. Colorectal cancer overlooked at barium enema examination and colonoscopy: a continuing perceptual problem. Radiology 1994; 192: 373-78.
Rex DK, Rahmani EY, Haseman JH, Lemmel GT, Kaster S. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology 1997; 112: 17-23.
Gelfand DW. Colorectal cancer. Screening strategies. Radiol Clin North Am 1997; 35: 431-8.
Sung JJ, Chan FK, Leung WK, Wu JC, Lau JY, Ching J, To KF, et al. Screening for colorectal cancer in Chinese: comparison of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Gastroenterology 2003; 124: 608-14.
Wineman AP. Screening for colorectal cancer. Guidelines for choosing the appropriate test for each patient. Postgrad Med 2003; 113: 49-55.
Walsh JM, Terdiman JP. Colorectal cancer screening: clinical applications. JAMA 2003; 289: 1297-302.
Klabunde CN, Frame PS, Meadow A, Jones E, Nadel M, Vernon SW. A national survey of primary care physicians’ colorectal cancer screening recommendations and practices. Prev Med 2003; 36: 352-62.
de Zwart IM, Griffioen G, Shaw MP, Lamers CB, de Roos A. Barium enema and endoscopy for the detection of colorectal neoplasia: sensitivity, specificity, complications and its determinants. Clin Radiol 2001; 56: 401-9.
Hunt DR, Cherian M. Endoscopic diagnosis of small flat carcinoma of the colon. Report of three cases. Dis Colon Rectum 1990; 33: 143-7.
Ott DJ. Accuracy of double-contrast barium enema in diagnosing colorectal polyps and cancer. Semin Roentgenol 2000; 35: 333-41.
McConnell JS, Nizin JS, Slade MS. Colonoscopy in patients with a primary family history of colon cancer. Dis Colon Rectum 1990; 33: 105-7.
Golub RW, Kerner BA, Wise WE Jr, Meesig DM, Hartmann RF, Khanduja KS, Aguilar PS. Colonoscopic bowel preparations —which one? A blinded, prospective, randomized trial. Dis Colon Rectum 1995; 38: 594-9.
Earle CC, Grunfeld E, Coyle D, Cripps MC, Stern HS. Cancer physicians’ attitudes toward colorectal cancer follow-up. Ann Oncol 2003; 14: 400-5.
Celestino A, Castillo T, Frisancho O, Contardo C, Espejo H, Tomioka C, Navarrete J. Colorectal cancer: study on 365 cases. Rev Gastroenterol Peru 1996; 16: 187-96.
Schneider AR, Caspary WF. Diagnosis of colorectal carcinoma. An update. Radiology 2003; 43: 105-12.
Gluecker TM, Johnson CD, Harmsen WS, Offord KP, Harris AM, Wilson LA, Ahlquist DA. Colorectal cancer screening with CT colonography, colonoscopy and double-contrast barium enema examination: prospective assessment of patient perceptions and preferences. Radiology 2003; 227: 378-84.
Lemon SC, Zapka JG, Estabrook B, Erban S, Luckmann R. Screening for colorectal cancer on the front line. Am J Gastroenterol 2003; 98: 915-23.
Kirchgatterer A, Hubner D, Aschl G, Hinterreiter M, Stadler B, Knoflach P. Colonoscopy and sigmoidoscopy in patients aged eighty years or older. Z Gastroenterol 2002; 40: 951-6.