BMJ Best Practice
最后审核时间: 十月 2018
最近更新时间: 九月 2018

小结

定义

病史和查体

关键诊断因素

  • 存在的危险因素
  • 年龄增长
  • 阳性家族史
  • 直肠出血

其他诊断因素

  • 贫血
  • 男性
  • 腹痛
  • 体重减轻和厌食

危险因素

  • 年龄增长
  • APC 基因突变
  • Lynch 综合征 (HNPCC)
  • MYH 相关的息肉病

诊断性检查

首要检查

  • 全血细胞计数(FBC)
  • 肝脏生化指标
  • 肾功能
  • 结肠镜检查
全部具体信息

需要考虑的检查

  • 盆腔磁共振成像 (MRI)
  • 经直肠内镜超声检查 (transrectal endoscopic ultrasound, TRUS)
  • 活检
  • 癌胚抗原 (carcinoembryonic antigen, CEA)
全部具体信息

治疗流程

贡献者

Associate Dean Clinical Operations

Chief

Division of Colorectal Surgery

Drexel University College of Medicine

Philadelphia

PA

利益冲突披露
DES declares that he has no competing interests.

Dr David E. Stein would like to gratefully acknowledge Dr Najjia Mahmoud, Dr Emily Carter Paulson, Dr Gary Atkin, Dr Anne Ballinger, Dr Mark O'Hara, Dr Mark Harrison, and Dr Robert Glynne-Jones, previous contributors to this topic. NM, ECP, MOH, GA, and AB declare that they have no competing interests. MH is the chair of the Mount Vernon Upper GI Tumour Site Specific Group and a member of the National Cancer Research Institute anal, rectal, and advanced colorectal groups. He has also received honoraria for speaking and has been supported to attend international meetings in GI cancer from Roche. He has also received research funding from Pfizer for a trial in rectal cancer. RGJ is the chief medical adviser to the charity Bowel Cancer UK. He has received honoraria for lectures from Roche, Sanofi, and Pfizer. He has received funding for the EXTRA study, involving capecitabine and radiotherapy in anal cancer, published in the International Journal of Radiation Biology Physics. RGJ has also received funding and free cetuximab for an ongoing phase I/II study integrating cetuximab into chemoradiation in rectal cancer, and has an agreement from Roche to supply bevacizumab for 3 months to 60 patients in one randomised phase II study as neoadjuvant chemotherapy in rectal cancer (BACCHUS). He has also been supported by Roche to attend international meetings in GI cancer.

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Consultant Colorectal Surgeon

St Mark's Hospital and Academic Institute

Northwick Park

Middlesex

UK

利益冲突披露
SC declares that she has no competing interests.

Chief of Staff

Chairman

Department of Colorectal Surgery

Cleveland Clinic

Weston

FL

利益冲突披露
SW declares that he has no competing interests.

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