Spigelman A D, Williams C B, Phillips R K
St Mark's Hospital, London.
J R Soc Med. 1992 Feb;85(2):77-9. doi: 10.1177/014107689208500208.
Almost all patients with familial adenomatous polyposis (FAP) develop duodenal polyps, the severity of which is graded stage 1 (minor) to stage V (cancer). Regular endoscopy is recommended for all patients with FAP. To test whether the development of severe duodenal polyposis could be predicted in another way, rectal and duodenal polyp severity were compared in 91 patients with FAP. The fulguration ratio (number of rectal fulgurations divided by number of years since colectomy) supplied the rectal polyp severity index. Patients with stage V duodenal polyposis had significantly higher fulguration ratios (median 0.38) than did patients with stage 1 disease (median 0; P = 0.009). However, the wide scatter of results means that rectal polyp severity cannot be used as a guide to duodenal polyp severity in individual patients. The coexistence of populations with severe duodenal and rectal polyposis suggests that environmental factors are important in phenotypic expression in FAP.
几乎所有家族性腺瘤性息肉病（FAP）患者都会出现十二指肠息肉，其严重程度分为1期（轻度）至V期（癌症）。建议所有FAP患者定期进行内镜检查。为了测试是否可以通过其他方式预测严重十二指肠息肉病的发生，对91例FAP患者的直肠和十二指肠息肉严重程度进行了比较。电灼率（直肠电灼次数除以结肠切除术后的年数）提供了直肠息肉严重程度指数。V期十二指肠息肉病患者的电灼率（中位数0.38）显著高于1期疾病患者（中位数0；P = 0.009）。然而，结果的广泛分散意味着直肠息肉严重程度不能作为个体患者十二指肠息肉严重程度的指导。严重十二指肠和直肠息肉病患者群体的共存表明环境因素在FAP的表型表达中很重要。
