McCashland T M, Brand R, Lyden E, de Garmo P
Department of Medicine, University of Nebraska Medical Center, Omaha 68198-3285, USA.
Am J Gastroenterol. 2001 Mar;96(3):882-6. doi: 10.1111/j.1572-0241.2001.3638_a.x.
To use a national endoscopy database (CORI) to determine 1) whether gender differences are noted in the prevalence and location of polyps and tumors; 2) whether women have a higher rate of right-sided polyps or tumors; and 3) whether age influences these results.
CORI database from April 1, 1997 to February 19, 1999, captured in a computer-generated report, was analyzed. Polyps for this study were defined as sessile or pedunculated and as >9 mm. Tumors were defined as lesions characteristic of adenocarcinoma (mass, apple-core). Pure right-sided colon (PRS) was defined as cecum, ascending, hepatic flexure; right-sided as PRS plus the transverse colon; and left-sided as the splenic flexure, descending, sigmoid and rectum.
Men have a greater risk of polyps [odds ratio (OR), 1.5] and tumors (OR, 1.4) than women. The risk of finding polyps and tumors at colonoscopy increases with age, with the highest risk noted in those >69 yr of age relative to patients <50 yr of age (polyps, OR = 2.7; tumors, OR = 4.0). Right-side polyps and pure right-sided polyps as defined by the study design were noted to be more frequent than left-sided polyps in patients >60 yr of age. Women have a greater risk of developing pure right-sided polyps (OR, 1.2), tumors (OR, 1.6) and right-sided tumors (OR, 1.5) than men.
Men have a higher prevalence of colon polyps and tumors than women. A progressive risk of polyp or tumor formation is noted with aging. Women had a greater number of pure right-sided polyps and tumor development. Colonoscopy is needed to correctly diagnose an increasing prevalence of right-sided pathology in the elderly.
利用一个全国性内镜数据库（CORI）来确定：1）息肉和肿瘤的患病率及位置是否存在性别差异；2）女性右侧息肉或肿瘤的发生率是否更高；3）年龄是否会影响这些结果。
对1997年4月1日至1999年2月19日CORI数据库中计算机生成报告所记录的数据进行分析。本研究中的息肉定义为无蒂或有蒂且直径大于9毫米。肿瘤定义为具有腺癌特征的病变（肿块、苹果核样）。单纯右侧结肠（PRS）定义为盲肠、升结肠、肝曲；右侧定义为PRS加上横结肠；左侧定义为脾曲、降结肠、乙状结肠和直肠。
男性患息肉[比值比（OR），1.5]和肿瘤（OR，1.4）的风险高于女性。结肠镜检查时发现息肉和肿瘤的风险随年龄增加而升高，相对于年龄小于50岁的患者，69岁以上患者的风险最高（息肉，OR = 2.7；肿瘤，OR = 4.0）。按照研究设计定义，60岁以上患者中右侧息肉和单纯右侧息肉比左侧息肉更常见。女性发生单纯右侧息肉（OR，1.2）、肿瘤（OR，1.6）和右侧肿瘤（OR，1.5）的风险高于男性。
男性结肠息肉和肿瘤的患病率高于女性。息肉或肿瘤形成的风险随年龄增长而逐渐增加。女性的单纯右侧息肉数量更多且肿瘤发生率更高。需要进行结肠镜检查以正确诊断老年人中右侧病变患病率的增加情况。
