【摘要】 目的 分析麻风病治愈患者结直肠癌及癌前病变的影响因素，为麻风病治愈患者预防结直肠癌提供依据。方法于2019—2020年选择浙江省各麻风村（院）麻风病治愈患者为研究对象，通过问卷调查收集人口学信息、肠息肉家族史、肠息肉病史、吸烟、饮酒、饮食行为和近3年排便情况等资料；进行肛指检查、电子结肠镜检查和组织病理学检查，诊断结直肠癌及癌前病变；采用多因素logistic回归模型分析麻风病治愈患者结直肠癌及癌前病变的影响因素。结果调查麻风病治愈患者100例，男性72例，女性28例；年龄（67.23±3.42）岁；麻风残疾为0级13例，1级16例，2级71例。检出结直肠癌5例，检出率为5.00%；癌前病变26例，检出率为26.00%。多因素logistic回归分析结果显示，≥65岁（OR=7.128,95%CI:5.019～10.123）、残疾（OR=4.591,95%CI:2.942～7.163）、有肠息肉病史（OR=4.031,95%CI:3.052～5.325）、常吃霉变食物（OR=4.433,95%CI:2.920～6.729）、不常吃蔬菜（OR=4.411,95%CI:3.204～6.071）、血便（OR=4.341,95%CI:2.771～6.799）、黏液便（OR=4.577,95%CI:2.771～7.559）、有抑郁情绪（OR=3.935,95%CI:3.026～5.117）与麻风病治愈患者发生结直肠癌及癌前病变存在统计学关联。结论 高龄、残疾、有肠息肉病史、常吃霉变食物、不常吃蔬菜、血便、黏液便、抑郁情绪可能增加麻风病治愈患者结直肠癌及癌前病变风险。更多还原

【Abstract】 Objective To investigate the influencing factors of colorectal cancer and precancerous lesions among curedleprosy patients, so as to provide insights into prevention of colorectal cancer among cured leprosy patients.Methods All cured leprosy patients were recruited from each leprosy village(hospital) in Zhejiang Province from 2019 to 2020.Participants’ demographic features, family and medical history of intestinal polyps, smoking, alcohol consumption, dietarybehaviors and defecation during the recent three years were collected using questionnaire surveys. Colorectal cancer andprecancerous lesions were diagnosed using rectal examination, electronic colonoscopy and histopathological examinations,and factors affecting the development of colorectal cancer and precancerous lesions were identified with a multivariablelogistic regression model among cured leprosy patients.Results Totally 100 cured leprosy cases were enrolled, includ-ing 72 men and 28 women, and with a mean age of(67.23±3.42) years. There were 13 cases with grade 0 leprosy dis-ability, 16 cases with grade 1 leprosy disability and 71 cases with grade 2 leprosy disability. The detection of colorec-tal cancer and precancerous lesions was 5.00% and 26.00%, respectively. Multivariable logistic regression analysisshowed that age of 65 years and older(OR=7.128, 95%CI: 5.019-10.123), disability(OR=4.591, 95%CI: 2.942-7.163),a medical history of intestinal polyps(OR=4.031, 95%CI: 3.052-5.325), eating moldy food frequently(OR=4.433, 95%CI: 2.920-6.729), seldom eating vegetables(OR=4.411, 95%CI: 3.204-6.071), bloody stools(OR=4.341, 95%CI:2.771-6.799), mucous stools(OR=4.577, 95%CI: 2.771-7.559) and presence of depression(OR=3.935, 95%CI: 3.026-5.117) were statistically associated with the development of colorectal cancer and precancerous lesions among cured lep-rosy patients.ConclusionAdvanced age, disability, history of intestinal polyps, frequent intake of moldy food, infre-quent consumption of vegetables, bloody stools, mucous stools, and depression may increase the risk of colorectal cancerand precancerous lesions among cured leprosy patients.更多还原