Oh Se Yong, Park Dong Il, Yoo Tae Woo, Kang Mun Su, Kim Sang Hoon, Park Jung Ho, Kim Hong Joo, Cho Yong Kyun, Sohn Chong Il, Jeon Woo Kyu, Kim Byung Ik, Son Byung Ho, Yoo Chang Hak
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2006 Mar;47(3):191-7.
BACKGROUND/AIMS: It has been reported that the risk of gastric polyp is increased in various colonic polyposis syndromes or in series of patients with sporadic colonic polyps. However, there are only a few large case controlled studies of colon cancer incidence in gastric cancer patients who underwent colonoscopy. The aims of this study were to determine the incidence of colorectal neoplasm and to evaluate the necessity of colonoscopic surveillance in patients with gastric cancer.
We performed colonoscopy in 105 patients with gastric cancer who agreed to undergo colonoscopy before or after 6 months from gastric resection between January 2002 and December 2004 in Kangbuk Samsung hospital. As a control group, 269 consecutive, age and sex matched patients without gastric neoplasm on gastroscopy who underwent colonoscopy within 6 months for the evaluation of various gastrointestinal symptoms during the year 2004 were included. Endoscopic reports and pathological results were reviewed retrospectively.
In the patient group, adenomatous polyps were diagnosed in 24/105 patients (22.9%) and colorectal adenocarcinoma in 10/105 patients (9.5%). In the control group, adenomatous polyps were diagnosed in 78/269 patients (29.0%) and colorectal adenocarcinoma in 2/269 patients (0.7%). The incidence of colorectal adenocarcinoma between the patient group and control group showed significant differences (odds ratio 11.04, p=0.003).
The risk of colorectal adenocarcinoma increases significantly in patients with gastric cancer. We suggest that the patients with gastric cancer might carry a high risk for colorectal cancer whom require surveillance colonoscopy.
背景/目的：据报道，在各种结肠息肉病综合征或散发性结肠息肉患者系列中，胃息肉的风险会增加。然而，对于接受结肠镜检查的胃癌患者，仅有少数关于结肠癌发病率的大型病例对照研究。本研究的目的是确定结直肠肿瘤的发病率，并评估胃癌患者进行结肠镜监测的必要性。
2002年1月至2004年12月期间，在江北三星医院，我们对105例同意在胃癌切除术前或术后6个月内接受结肠镜检查的胃癌患者进行了结肠镜检查。作为对照组，纳入了269例连续的、年龄和性别匹配的患者，这些患者在2004年因评估各种胃肠道症状而在6个月内接受了胃镜检查且无胃肿瘤。回顾性地审查了内镜报告和病理结果。
在患者组中，24/105例患者（22.9%）被诊断为腺瘤性息肉，10/105例患者（9.5%）被诊断为结直肠癌。在对照组中，78/269例患者（29.0%）被诊断为腺瘤性息肉，2/269例患者（0.7%）被诊断为结直肠癌。患者组和对照组之间结直肠癌的发病率显示出显著差异（优势比11.04，p = 0.003）。
胃癌患者患结直肠癌的风险显著增加。我们建议，胃癌患者可能患结直肠癌的风险较高，需要进行监测结肠镜检查。
