Bond J H
Gastroenterology Section, Minneapolis VA Medical Center, and University of Minnesota, 55417, USA.
Semin Gastrointest Dis. 2000 Oct;11(4):176-84.
A large body of clinical evidence supports the belief that over 95% of colorectal cancers arise in benign adenomatous polyps that develop and grow very slowly over many years. Interruption of the adenoma-carcinoma sequence by resecting adenomatous polyps is a powerful method of secondary prevention of colorectal cancer. Colonoscopy is the procedure of choice for the diagnosis and resection of colorectal polyps. Patients who have had colonoscopic resection of adenomas, and in some cases their close relatives, are at increased risk for developing metachronous polyps and cancer and may benefit from follow-up colonoscopic surveillance. This surveillance should be individually tailored to the perceived risk of each case depending on the features of the adenomas removed and other patient factors such as family history. Widespread adoption of current postpolypectomy guideline recommendations is protective and conserves medical resources.
大量临床证据支持这样一种观点，即超过95%的结直肠癌起源于良性腺瘤性息肉，这些息肉在多年间发展缓慢。通过切除腺瘤性息肉来阻断腺瘤-癌序列是结直肠癌二级预防的有力方法。结肠镜检查是诊断和切除结直肠息肉的首选方法。接受过腺瘤结肠镜切除术的患者，在某些情况下其近亲，发生异时性息肉和癌症的风险增加，可能受益于后续的结肠镜监测。这种监测应根据所切除腺瘤的特征和其他患者因素（如家族史），针对每个病例的感知风险进行个体化调整。广泛采用当前息肉切除术后指南建议具有保护作用并节省医疗资源。
