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肢端肥大症患者结肠息肉的患病率并未增加:对来自印度的60例患者的分析。

Prevalence of colonic polyps is not increased in patients with acromegaly: analysis of 60 patients from India.

作者信息

Bhansali Anil, Kochhar Rakesh, Chawla Yogesh K, Reddy Somashekara, Dash Radharaman Jiban

机构信息

Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J Gastroenterol Hepatol. 2004 Mar;19(3):266-9. doi: 10.1111/j.1440-1746.2003.03282.x.

Abstract

BACKGROUND

There are conflicting data on the prevalence of colorectal adenomas in patients with acromegaly. It has been suggested that the risk of colorectal adenomas may be dependent on the geographic and ethnic origin of the patients.

MATERIALS

Sixty consecutive patients with active acromegaly due to somatotropinoma underwent colonoscopy prior to definitive surgery. They included 35 men and 25 women with a mean (+/- SD) age of 37.4 +/- 13.2 years and a lag time between symptomatology and diagnosis of acromegaly of 64.6 +/- 58.0 months. The control group included 160 patients (88 men, 72 women; mean age, 38.2 +/- 14.0 years) with a diagnosis of irritable bowel syndrome who were also subjected to colonoscopy. None of these patients had previous or family history of colonic neoplasm, bleeding or colonic surgery.

RESULTS

Colonoscopic examination was complete to the cecum in 52 patients (88%), and to the splenic flexure in the remaining 12%. In the control group, it was complete to the cecum in 144 patients (90%). Four of the acromegalic patients (6.7%) and five in the control group (3.1%; P=0.24) had hyperplastic polyps. No patient in either of the groups had adenomatous polyps or colonic adenocarcinoma. The group of acromegalic patients with and without polyps did not differ significantly in age, duration of disease, growth hormone levels or glycemic status. The number of skin tags, however, was significantly higher (P=0.04) in the polyp group as compared to those without polyps.

CONCLUSION

The present study has failed to demonstrate the high prevalence rate of colonic neoplasia in patients with acromegaly as compared to reports from the Western world.

摘要

背景

关于肢端肥大症患者结直肠腺瘤的患病率,存在相互矛盾的数据。有人提出,结直肠腺瘤的风险可能取决于患者的地理和种族来源。

材料

60例因生长激素瘤导致的活动性肢端肥大症患者在确定性手术前接受了结肠镜检查。其中包括35名男性和25名女性,平均(±标准差)年龄为37.4±13.2岁,从出现症状到诊断为肢端肥大症的间隔时间为64.6±58.0个月。对照组包括160例诊断为肠易激综合征的患者(88名男性,72名女性;平均年龄38.2±14.0岁),他们也接受了结肠镜检查。这些患者均无结肠肿瘤、出血或结肠手术的既往史或家族史。

结果

52例患者(88%)的结肠镜检查完整至盲肠,其余12%完整至脾曲。在对照组中,144例患者(90%)的结肠镜检查完整至盲肠。4例肢端肥大症患者(6.7%)和对照组5例患者(3.1%;P=0.24)有增生性息肉。两组中均无患者有腺瘤性息肉或结肠腺癌。有息肉和无息肉的肢端肥大症患者组在年龄、病程、生长激素水平或血糖状态方面无显著差异。然而,息肉组的皮赘数量明显高于无息肉组(P=0.04)。

结论

与西方世界的报告相比,本研究未能证明肢端肥大症患者结肠肿瘤的高患病率。

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