Rudolph Rebecca E, Dominitz Jason A, Lampe Johanna W, Levy Lisa, Qu Pingping, Li Shuying S, Lampe Paul D, Bronner Mary P, Potter John D
Veterans Affairs Puget Sound Health Care System, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):605-8. doi: 10.1158/1055-9965.EPI-04-0058.
Several characteristics of aberrant crypt foci (ACF) suggest that they are precursors of colorectal cancer, but the factors that promote or inhibit their growth are largely unknown. We conducted a pilot study to explore whether factors associated with risk of colorectal cancer are also associated with number or size of rectal ACF. Thirty-two U.S. veterans, ages 50 to 80 years, were recruited to undergo magnifying chromoendoscopy for imaging of rectal ACF and colonoscopy for identification of polyps or cancer. Participants completed a questionnaire on cigarette smoking, use of nonsteroidal anti-inflammatory drugs (NSAIDs), and family history of colorectal cancer. Fisher's exact test was used to assess the statistical significance of associations between colorectal cancer risk factors and characteristics of ACF. Cochran-Mantel-Haenszel statistics and polytomous regression were used to test the significance of associations adjusted for age. Participants with a history of adenoma had more ACF than those without (age-adjusted P = 0.02), but the numbers in the two groups overlapped markedly. Older participants had more (P = 0.06) and larger (P = 0.009) ACF than younger participants. No associations were identified between either ACF number or size and cigarette smoking, use of NSAIDs, or family history of colorectal cancer. These findings suggest that persons with adenomas have somewhat more rectal ACF than persons without, and that older age is a risk factor for ACF growth. Future research should be directed toward developing techniques to identify ACF that are likely to progress to cancer and the modifiable factors that promote or inhibit such progression.
异常隐窝病灶（ACF）的几个特征表明它们是结直肠癌的前体，但促进或抑制其生长的因素在很大程度上尚不清楚。我们进行了一项试点研究，以探讨与结直肠癌风险相关的因素是否也与直肠ACF的数量或大小有关。招募了32名年龄在50至80岁之间的美国退伍军人，接受放大染色内镜检查以对直肠ACF进行成像，并接受结肠镜检查以识别息肉或癌症。参与者完成了一份关于吸烟、使用非甾体抗炎药（NSAIDs）以及结直肠癌家族史的问卷。采用Fisher精确检验来评估结直肠癌风险因素与ACF特征之间关联的统计学意义。使用 Cochr an-Mantel-Haenszel统计量和多分类回归来检验经年龄调整后的关联的显著性。有腺瘤病史的参与者比没有腺瘤病史的参与者有更多的ACF（年龄调整后P = 0.02），但两组的数量有明显重叠。老年参与者比年轻参与者有更多（P = 0.06）且更大（P = 0.009）的ACF。未发现ACF数量或大小与吸烟、使用NSAIDs或结直肠癌家族史之间存在关联。这些发现表明，有腺瘤的人直肠ACF比没有腺瘤的人略多，并且年龄较大是ACF生长的一个风险因素。未来的研究应致力于开发技术，以识别可能发展为癌症的ACF以及促进或抑制这种进展的可改变因素。
