目的 探讨原发性肝癌患者肝静脉压力梯度(hepatic vein pressure gradient,HVPG)与门静脉压力梯度(portal pressure gradient,PPG)相关性.方法 161 例原发性肝癌患者在TIPS术中测量下腔静脉压力(inferior vena cava pressure,ICVP)、肝静脉自由压(free hepatic vein pressure,FHVP)、肝静脉楔压(wedged hepatic vein pressure,WHVP)和门静脉压力(portal vein pressure,PVP),计算HVPG(HVPG=WHVP-FHVP)和PPG(PPG=PVP-IVCP).结果 161例患者HVPG为(20.18±9.22)mmHg,PPG为(26.44±6.82)mmHg,2 者无相关性(r=0.112);PPG明显高于HVPG(P＜0.05).HVPG与PPG相差在 5 mmHg以上者 90 例,占 55.9％,HVPG与PPG相差在 5 mmHg以内者 71 例,占 44.1％.球囊阻断肝静脉造影有肝内静脉-静脉侧支分流(intrahepatic venous-venous collateral shunt,HVVC)者 42 例(26.09％),HVPG为(10.91±6.11)mmHg,PPG为(28.43±6.11)mmHg,2 者呈弱相关(r=0.384);PPG显著高于HVPG(P＜0.05).球囊阻断肝静脉造影无HVVC者119例,HVPG为(23.45±7.81)mmHg,PPG为(25.74±6.94)mmHg,2者呈弱相关(r=0.249);PPG明显高于HVPG(P＜0.05).结论 原发性肝癌合并门静脉高压(portal hypertension,PHT)HVPG与PPG总体相关性差,大部分患者的HVPG不能准确代表PPG,并且前者低于后者;有HVVC形成是严重低估HVPG值的重要原因.

Objective:To investigate the incidences of metachronous advanced adenoma (MAA) in patients with simultaneous multiple primary colorectal cancer (CRC) and patients with sporadic CRC.Methods:From January 1, 2008 to September 30, 2022, at Beijing Shijitan Hospital, Capital Medical University, CRC patients who underwent surgery and 3 years follow-up with endoscopy were enrolled. The patients completed colonoscopy at least 2 times during follow-up in 6 to 36 months after surgery, and the interval between the 2 times colonoscopies was over 6 months. Clinical data including age, gender, and tumor location, stage, pathological features, combined underlying diseases, preoperative carcinoembryonic antigen, hemoglobin and other laboratory results, baseline colonoscopy results, and detection of MAA were collected. According to age (±2 years old), gender, location of primary lesion and stage of tumor, patients with simultaneous CRC or sporadic CRC were matched at 1∶1 ratio by propensity score matching. The cumulative risks of MAA in patients with simultaneous multiple primary CRC and patients with sporadic CRC were calculated. Cox proportional hazard regression was used to analyze the influencing factors in the occurrence of MAA.Results:A total of 814 CRC patients were enrolled and matched. After paired matching, there were 36 cases of simultaneous multiple primary CRC (78 lesions) and 78 cases of sporadic CRC (78 lesions). The cumulative incidences of MAA at 1, 2 and 3 years of simultaneous CRC group were 11.1%(4/36), 22.2%(8/36) and 33.3%(12/36), respectively. The cumulative incidences of MAA at 1-, 2- and 3-year of sporadic CRC group were 3.8%(3/78), 12.8%(10/78) and 20.5%(16/78), respectively.Simultaneous CRC was correlated with an increase in the 3-year cumulative incidence of MAA ( HR=4.163, 95% confidence interval(95% CI) 1.032 to 4.721, P=0.047). Especially in left-sided CRC, the risk of MAA in simultaneous CRC increased ( HR=7.186, 95% CI 1.602 to 20.787, P=0.010). The results of multivariate cox-regression analysis indicated that detection of simultaneous advanced adenoma at baseline endoscopy was an independent risk factor of MAA ( HR=3.175, 95% CI 1.411 to 7.142, P=0.005). Conclusion:Colouoscopy follow-up should be strengthened in patients with simultaneous multiple primary CRC and simultaneous advanced adenomas.

ObjectiveTo investigate the value of Baveno Ⅶ criteria versus Expanded Baveno Ⅶ criteria in screening for high-risk varices (HRV) in patients with compensated advanced chronic liver disease (cACLD). MethodsA total of 146 patients with cACLD who were admitted to Beijing Shijitan Hospital, Capital Medical University, from January 2016 to December 2018 were enrolled, and according to the absence or presence of HRV based on gastroscopy, they were divided into HRV group with 68 patients and control group with 78 patients. Clinical data, liver stiffness measurement (LSM), and gastroscopy findings were analyzed, and different Baveno Ⅶ criteria were analyzed in terms of their sensitivity and specificity in the diagnosis of HRV. The Mann-Whitney U test and the McNemar test were used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. A univariate logistic regression analysis was performed for the variables used to predict HRV, and a multivariate analysis was performed for the variables with P＜0.1. The two sets of Baveno Ⅶ criteria were compared in terms of their sensitivity and specificity in the diagnosis of HRV. ResultsA total of 146 patients were enrolled in the study, among whom 68 (46.6%) were found to have HRV. The median age was 54 years (range 29-84 years), male patients accounted for 65.8%, and hepatitis B virus was the main etiology observed in 115 patients (78.8%). The univariate logistic regression analysis showed that LSM and platelet count (PLT) were associated with HRV (both P＜0.05). The multivariate analysis showed that based on Baveno Ⅶ criteria, LSM ＞20 kPa or PLT ＜150×109/L was associated with HRV (both P＜0.05), and based on Expanded Baveno Ⅶ criteria, LSM ＞25 kPa or PLT ＜110×109/L was associated with HRV (both P＜0.05). LSM and PLT had an area under the ROC curve of 0.797 (95% confidence interval ［CI］: 0.723-0.859) and 0.789 (95% CI: 0.714-0.852), respectively, in the diagnosis of HRV. There were significant differences in the prevalence rates of esophageal and gastric varices and HRV between the patients who met Baveno Ⅶ criteria and those who did not meet such criteria (χ2=23.14 and 23.14, both P＜0.001), as well as between the patients who met Expanded Baveno Ⅶ criteria and those who did not meet such criteria (χ2=43.51 and 25.71, both P＜0.001). Although a higher proportion of patients were exempted from gastroscopy based on Expanded Baveno Ⅶ criteria (32.9% vs 13.7%), Baveno Ⅶ criteria had higher sensitivity (0.98 vs 0.88) and negative predictive value (095 vs 0.83) and could better avoid the missed diagnosis of HRV (1.0% vs 9.3%). ConclusionBaveno Ⅶ criteria are more suitable for the screening for HRV in cACLD patients in China.

本文采用CT肝脏灌注成像对原发性肝癌(PHC)血供特点进行观察并评价肝动脉化疗栓塞术(TACE)后血流灌注状况.选取70例经肝活检证实为PHC的患者为研究对象,均进行TA-CE治疗,TACE干预前后进行CT肝脏灌注成像并评估效果,分析CT肝脏灌注成像对PHC患者短期疗效的价值.与非瘤区组织相比,肿瘤活性灶肝血流量(HBF)、肝动脉灌注指数(HPI)、肝动脉灌注量(HAP)较高,达峰时间(TTP)较低(P＜0.05).与无效患者相比,有效患者微血管密度(MVD)、血管内皮生长因子(VEGF)较低(P＜0.05).与干预前相比,干预后HBF、HPI、HAP较低,TTP 较高(P＜0.05).HBF、HPI、HAP 及 TTP 联合诊断的 AUC 为 0.940(P＜0.05),对PHC患者近期疗效的诊断效能较高(P＜0.05).CT肝脏灌注成像有助于评估患者PHC患者TACE术后血流状态,临床价值较高.

目的 分析首都医科大学附属北京世纪坛医院结肠镜发现的肿块型回肠肿瘤的临床诊治情况.方法 通过电子病历系统检索收集2010年1月至2019年12月在首都医科大学附属北京世纪坛医院住院的、诊治资料完整的、经结肠镜发现的回肠肿瘤患者(肿块型),共5例.收集所有患者的年龄、性别、临床表现、既往史、体征、实验室检查、腹部影像学检查、结肠镜结果、手术和术后病理、其他治疗和随访等,并进行分析.结果 5例患者中,男3例,女2例,年龄28～58岁.腹痛、便血、排气排便减少、大便习惯改变为主要临床表现.4例腹部CT提示小肠-结肠型肠套叠,1例提示回盲部占位、伴肝转移.结肠镜提示:1例于回肠末端见一4 cm×3 cm大小分叶肿物,色稍红,于回盲瓣和小肠内滑进滑出;2例提示结肠肝曲肿物,头端2～4 cm大小,色红,表面黏液附着,可见"长蒂"(小肠绒毛)连接至回盲部,活检病理1例提示非霍奇金淋巴瘤、1例提示炎症;1例提示一累及回盲部和升结肠的巨大肿物,根部可见小肠绒毛样结构,活检病理提示炎症;1例提示回肠末端肿物,约占据1/2管腔,活检病理提示炎症.5例患者均经腹腔镜手术切除肿物,术后病理分别提示脂肪瘤、高级别B细胞淋巴瘤、炎症性肌纤维母细胞瘤、促纤维组织增生性小圆细胞肿瘤和神经纤维瘤.结论 结肠镜发现的肿块型回肠肿瘤临床和内镜表现均无特征性,部分可出现小肠-结肠型肠套叠,腹部CT是重要的术前诊断方法,手术是重要的诊治手段,确诊需手术病理.

Objective:By using balloon occlusive hepatic angiography in cirrhotic portal hypertension to evaluate contrast doses on the detection rate of intrahepatic venous-lateral branch shunt (HVVC), and the effect on hepatic venous pressure gradient (HVPG) and portal vein pressure gradient (PPG).Methods:From Jan 2018 to Jun 2021, 131 patients received transjugular intrahepatic portosystemic shunt (TIPS) at Beijing Shijitan Hospital.Results:A positive correlation between PVP and weged hepatic venous pressure (WHVP) ( r=0.241, P=0.001) was found when only by right hepatic vein approach. Ten ml of iodine contrast medium when compared to 5ml doses found more cases of intrahepatic venous-venous lateral branch shunt. The mean PPG of patients with HVVC was significantly higher than the mean of HVPG( P<0.05).The right hepatic vein was the only reliable vein by which WHVP was measured. Conclusions:Right hepatic vein manometry,adequate ballon occlusion and using 10ml of iodine contrast help get reliable WHVP and found HVVC; HVVC can affect the consistency of HVPG and PPG.

ObjectiveTo investigate the influencing factors for the clinical effect of emergency endoscopic therapy in the treatment of patients with acute-on-chronic liver failure and gastroesophageal variceal bleeding. MethodsA total of 51 patients with acute-on-chronic liver failure and gastroesophageal variceal bleeding who underwent emergency endoscopic therapy in Beijing Shijitan Hospital and The Fifth Medical Center of Chinese PLA General Hospital from January 2016 to December 2018 were enrolled, among whom 26 had successful hemostasis and 25 had failed hemostasis. The two groups were compared in terms of general information, varices grade and bleeding manifestations under endoscope, blood biochemical parameters, ultrasound findings, Child-Pugh class, and Model for End-Stage Liver Disease (MELD) score, and the influencing factors for the outcome of hemostasis were analyzed. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups; the logistic regression model was used to perform the multivariate analysis. ResultsOf all patients, 26 achieved successful hemostasis, with a success rate of hemostasis of 51%. There were no significant differences between the two groups in sex, age, etiology of liver cirrhosis, presence or absence of liver cancer, presence or absence of portal vein thrombosis, bleeding for the first time or not, white blood cell count, hemoglobin, platelet count, prothrombin time activity, alanine aminotransferase, total bilirubin, albumin, cholinesterase, MELD score, and bleeding site and bleeding manifestations under gastroscope (all P＞0.05). Compared with the failed hemostasis group, the successful hemostasis group had a significantly longer course of disease (t=2.760, P=0.008) and significantly larger portal vein diameter and diameter of varicose veins under endoscope (t=-4.847, χ2=-6.590, both P＜0.05), and the failed hemostasis group had a significantly higher proportion of patients with Child-Pugh class C disease than the successful hemostasis group (χ2=5.684, P=0.017). Course of liver cirrhosis (odds ratio ［OR］=0.913, 95% confidence interval ［CI］: 0.838-0.994, P＜0.05), portal vein diameter (OR=1.925,95%CI: 1.516-2.443, P＜0.05), and diameter of varicose veins (OR=23.254, 95%CI: 2.250-240.352, P＜0.05) were independent influencing factors for the clinical effect of endoscopic hemostasis. ConclusionThere is a relatively low success rate of emergency endoscopic hemostasis in patients with acute-on-chronic liver failure, and course of liver cirrhosis, portal vein diameter, and diameter of varicose veins are independent influencing factors for the clinical effect of endoscopic hemostasis.

Objective:To explore whether the regular feedback system in opportunistic screening of colorectal cancer can improve the adenoma detection rate (ADR) of endoscopists.Methods:This study was an observational study, divided into three stages: the baseline stage before intervention (the pre-intervention period), the regular feedback stage (the intervention period) and the post-intervention stage (the post-intervention period). In the pre-intervention period, all patients who underwent opportunistic screening of colorectal cancer in Department of Gastroenterology in Beijing Shijitan Hospital Affiliated to Capital Medical University from June 2017 to May 2018 were reviewed, and the ADR of each endoscopist was calculated. In the intervention period from June 2018 to November 2018, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist during the previous month was calculated at the beginning of each month and feedback was provided in the form of a report. In the post-intervention period from December 2018 to January 2019, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist was calculated after the feedback stopped. ADR and polyp detection rate (PDR) of three stages were compared.Results:A total of 1 768, 1 308 and 344 patients were enrolled for opportunistic screening of colorectal cancer during the pre-intervention, the intervention and the post-intervention period respectively. Eight endoscopists participated in the whole process of this study. The total ADR increased from 23.70% (419/1 768) in the pre-intervention period to 33.72% (441/1 308) in the intervention period ( χ2=37.449, P<0.05). Two months after intervention, ADR decreased slightly to 33.14% (114/344), but was still higher compared with before ( χ2=13.602, P<0.05). The total PDR increased from 47.17% (834/1 768) in the pre-intervention period to 52.68% (689/1 308) in the intervention period ( χ2=9.111, P<0.05). Two months after the intervention, PDR increased slightly to 53.78% (185/344), and still higher compared with before ( χ2=5.035, P<0.05). Conclusion:Regular feedback to endoscopists can improve ADR in opportunistic screening of colorectal cancer.

目的 探讨不同进食时间对急性胰腺炎患者术后疗效及胃肠功能恢复、体液免疫指标的影响.方法 回顾性分析我院于2010年1月至2020年1月收治的经手术治疗的100例AP患者临床资料,根据患者术后进食时间,分为三组:A组24 h内进食,B组24～48 h内开始进食,C组48～72 h开始进食,对比三组患者手术指标、疗效、营养状况、胃肠功能恢复情况、免疫功能及并发症发生率.结果 治疗总有效率比较A组(91.2％)>B组(85.1％)>C组(82.1％),但差异无统计学意义(P>0.05);三组患者手术时间、术中出血量及术后切口恢复情况差异无统计学意义(P>0.05);自觉肠蠕动时间、首次排气时间、排便时间比较A组B组>C组,差异具有统计学意义(P<0.05);三组术后白蛋白和前白蛋白水平显著升高(P<0.05),组间比较A组高于B组和C组(P<0.05);三组术后各项免疫指标均先下降后升高(P<0.05),组间比较A组高于B组和C组(P<0.05);拆线时间、总住院时间和住院总费用比较A组

Background:Detailed catalog of lung cancer-associated gene mutations provides valuable information for lung cancer diagnosis and treatment. In China, there has never been a wide-ranging study cataloging lung cancer-associated gene mutations. This study aims to reveal a comprehensive catalog of lung cancer gene mutations in china, focusing on EGFR, ALK, KRAS, HER2, PIK3CA, MET, BRAF, HRAS, and CTNNB1 as major targets. Additionally, we also aim to correlate smoking history, gender, and age distribution and pathological types with various types of gene mutations. Patients and Methods:A retrospective data acquisition was conducted spanning 6 years (2013-2018) among all patients who underwent lung cancer surgeries not bronchial or percutaneous lung biopsy at three major tertiary hospitals. Finally, we identified 1,729 patients who matched our inclusion criteria. Results:1081 patients (62.49%) harbored EGFR mutation. ALK (n= 42, 2.43%), KRAS (n= 201, 11.62%), CTNNB1 (n= 28, 1.62%), BRAF (n= 31, 1.79%), PIK3CA (n= 51, 2.95%), MET (n= 14, 0.81%), HER2 (n= 47, 2.72%), HRAS (n= 3, 0.17%), and other genes(n= 232, 13.4%). Females expressed 55.38% vs. males 44.62% mutations. Among subjects with known smoking histories, 32.82% smokers, 67.15% non-smokers were observed. Generally, 51.80% patients were above 60 years vs. 48.20% in younger patients. Pathological types found includes LUADs 71.11%, SQCCs 1.68%, ASC 0.75%, LCC 0.58%, SCC 0.35%, ACC 0.17%, and SC 0.06%, unclear 25.19%. Conclusion:We offer a detailed catalog of the distribution of lung cancer mutations. Showing how gender, smoking history, age, and pathological types are significantly related to the prevalence of lung cancer in China.

目的 评估超声内镜结合内镜食道静脉瘤套扎器行内镜下圈套器法黏膜切除术(EMR-L)治疗直肠神经内分泌肿瘤(NENs)的临床有效性、安全性以及技术的可行性.方法 回顾性分析北京世纪坛医院消化内科2015年11月-2017年11月收治的13例直肠NENs患者临床资料,治疗前均行超声内镜检查,后进行EMR-L切除病变.观察患者内镜表现、EMR-L操作过程及其并发症、病理结果,术后定期结肠镜随访.结果 13例患者顺利完成EMR-L切除病变,耗时10 min 36 s～52 min 21 s,平均(21.9±10.6)min.1例患者发生急性出血,予药物喷洒及钛夹封闭创面治疗后出血停止.无急性或迟发性直肠出血、穿孔等并发症.结论 应用内镜食道静脉瘤套扎器行EMR-L可有效、安全的切除小于1.0 cm的直肠NENs,同时治疗费用较食管静脉曲张连环套扎器少,有很好的临床应用价值.

目的 探讨氯雷他定联合法莫替丁治疗嗜酸性粒细胞性胃肠炎的临床疗效.方法 选取2016年12月—2017年12月首都医科大学附属北京世纪坛医院收治的嗜酸性粒细胞性胃肠炎的患者42例,随机分为对照组和治疗组,每组各21例.对照组餐前口服法莫替丁片,20 mg/次,2次/d.治疗组在对照组治疗基础上口服氯雷他定片,10 mg/次,1次/d.两组均连续治疗8周.观察两组的临床疗效,比较两组治疗前后血嗜酸粒细胞计数、组织嗜酸粒细胞计数、IgE水平的变化情况.结果 治疗后,对照组和治疗组的总有效率分别为80.95%和95.23%,两组比较差异有统计学意义(P<0.05).治疗后,两组患者血嗜酸粒细胞计数、组织嗜酸粒细胞计数、IgE水平均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组血嗜酸粒细胞计数、组织嗜酸粒细胞计数、IgE水平显著低于对照组,两组比较差异有统计学意义(P<0.05).结论 氯雷他定联合法莫替丁治疗嗜酸性粒细胞性胃肠炎具有较好的临床疗效,降低患者外周血及组织中嗜酸性粒细胞水平,具有一定的临床推广应用价值.

Objective To investigate the effect of comprehensive internal medical treatment including gastric endoscopy on patients with bezoar. Methods From 2010 to 2016,a retrospective study was conducted on fifty?two patients admitted to Beijing Shijitan Hospital, Capital Medical University. Results The main accompanying diseases were hypertension,coronary heart disease,diabetes mellitus and so on. Food that are easy to induce bezoar : banana, persimmon, hawthorn, chestnut, etc. The treatment included endoscopic treatment, intravenous proton pump suppression, and oral Coca?Cola and bicarbonate solution. The bezoar in two patients after 3 weeks of medical treatment were still not dissolved,finally surgery were performed. One patient's pathology showed early cardiac adenocarcinoma. Five patients had incomplete intestinal obstruction, after fasting and gastrointestinal decompression, and the bezoars were excreted through feces. All patients were cured without death. Conclusion Gastroscopy is a timely treatment that can help diagnose and treat gastric bezoar. The main predisposing factors include hypertension, coronary heart disease, diabetes mellitus and so on. Endoscopic treatment,intravenous proton pump inhibitor,sodium bicarbonate and Coca?Cola could dissolve most bezoar. We should be alert to the possibility of early cancer.

untypical manifestations.Here we report such a case in a patient who was diagnosed with "esophageal cancer" at admission.Repeated endoscopy and endoscopic ultrasonography,combined with the patient's history and related test results,resulted in a final diagnosis of Behcet's disease.Our case suggests that the diagnosis of Behcet's disease with untypical manifestations depends on the comprehensive analysis of clinical manifestations,the patient's history,and imaging findings.Endoscopic ultrasonography has its unique advantages in evaluating the depth of esophageal lesion infiltration and the therapeutic effect during follow-up.

Objective To investigate the practical efficiency of a novel disposable-sheathed gastroscope system in visit round of remote areas.Methods A total of 1120 participants were randomized to accept gastroscopy with either a disposable-sheathed gastroscope system (n =568) or a standard system (n =552).The duration of the endoscopic procedure and cleaning and disinfection was recorded.The results of gastroscopy,the feedback of the procedure from patients and any adverse events presented during the procedure were also recorded.Results The mean procedure time was significantly longer with the sheathed system (4.9 ± 1.4 min) than with the standard one (4.1 ± 1.3 min,t =5.689,P =0.000).However,the duration of cleaning and disinfection were significantly shorter with the sheathed gastroscope (4.9 ±0.2 min) than with the standard one (35.0 ±0.2 min,t =-1271.145,P =0.000).So the total instrument turn-over time for sheathed system was only a quarter of the time for standard endoscope (9.9 ± 1.3 vs.39.0 ± 1.4 min).The detection rate of abnormalities and patients'feedback were similar between with two systems.No sheath leakage or rupture was observed.Conclusion The sheathed gastroscope system is safe,convenient and rapid in manipulation,and is valuable in clinical practice,especially in visit rounds of remote areas.

Objective To evaluate the efficacy of fecal transferrin(TF) and immuno fecal occult blood test(IFOBT) for colorectal neoplasms screening.Methods A total of 1,943 asymptomatic subjects were recruited for the study.Fecal sample was collected for concurrent TF and IFOBT testing.Colonoscopy were performed for individuals positive of either TF or IFOBT.Performance characteristics for TF alone,IFOBT alone and combined TF and IFOBT were calculated respectively.Results 1,737 individuals were tested for TF and IFOBT,251 subjects(14.5%) showed either TF or IFOBT positive.Colonoscopy was performed in 193 of the 251 individuals.A total of 3 colorectal cancers and 43 advanced adenomas were detected.Combination of the two tests(either/or) significantly increased the detection rate for colorectal cancers and advanced adenomas compared to IFOBT alone(2.6 % vs 1.6 %,P=0.034).Conclusion Combined TF and IFOBT test can increase the detection rate of colorectal adenoma and cancer.

Objective To explore the potential application of Vimentin gene methylation in early clinical diagnosis of colorectal cancer from patients' fecal DNA.Methods Genomic DNA were extracted from fresh normal and cancer tissues as well as tumor patients' stool.After bisulfite conversion of DNA,the Vimentin gene methylation was detected by methylation-specific PCR and then identified by agrose gel electrophoresis.Results Vimentin gene methylation was not detected in normal colon and rectum tissues while the detecting rate of Vimentin gene methylation was 83% in cancer tissues.In fecal DNA, the detecting rate of methylation was 36% in all colorectal cancer patients and increases to 66.7% if only observing early rectal cancer.Conclusion Vimentin gene methylation has a clinical significance in rectal cancer early diagnosis.

In recent years,the incidence of colorectal cancer is increasing year by year.Usually,early colorectal cancer which can be found by screening has no clinical symptoms.At present,fecal occult blood test(FOBT) is a common method of colorectal cancer screening,but the limitations of FOBT are high false negative and false positive.To make up its shortcomings,detections of exfoliative cells and relative markers were carried out to search for new methods of colorectal cancer early diagnosis.This paper will systematically review the research advances in recent years.