20岁之前的晚期结肠癌：关于扩大遗传性非息肉病性结直肠癌综合征当前结肠镜监测指南范围的一个案例
Advanced colon cancer before the age of 20 years: a case for extension of the current colonoscopy surveillance guidelines in hereditary nonpolyposis colorectal cancer syndrome.
作者信息
Wong Victor K, Yoshida Eric M, Ryan Anthony G, Ho Stephen G F, Salh Baljinder
机构信息
Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
出版信息
Can J Gastroenterol. 2004 May;18(5):319-20. doi: 10.1155/2004/746174.
BACKGROUND
Hereditary nonpolyposis colorectal cancer (HNPCC) currently accounts for between 2% to 6% of all colorectal adenocarcinomas. Controversies exist regarding the current guidelines for colonoscopic screening for colon cancer.
CASE REPORT
A case of colon cancer in a young Japanese man with a family history of colon cancer that did not meet the criteria for HNPCC is reported. A malignant pelvic mass discovered shortly before his 20th birthday prompted a colonoscopy. The findings at colonoscopy determined that the patient and his family fulfilled the criteria of HNPCC.
CONCLUSION
Before finding a pelvic mass metastatic from adenocarcinoma of the ascending colon, this patient was clearly outside of the current guidelines for HNPCC screening. It is suggested that in similar patients, even if they do not fulfill all the criteria for HNPCC, it would be appropriate to consider screening well before the recommended lower age.
背景
遗传性非息肉病性结直肠癌（HNPCC）目前占所有结直肠腺癌的2%至6%。关于目前结肠癌结肠镜筛查指南存在争议。
病例报告
报告了一例年轻日本男性患结肠癌的病例，其有结肠癌家族史，但不符合HNPCC标准。在他20岁生日前不久发现的恶性盆腔肿块促使进行了结肠镜检查。结肠镜检查结果确定该患者及其家族符合HNPCC标准。
结论
在发现升结肠癌转移至盆腔肿块之前，该患者显然不在目前HNPCC筛查指南范围内。建议在类似患者中，即使他们不符合HNPCC的所有标准，在推荐的较低年龄之前提前考虑进行筛查也是合适的。
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