Iwasaki Junko, Sano Yasushi, Fu Kuang-I, Machida Ai, Okuno Tatsuya, Kuwamura Hikaru, Yoshino Takayuki, Mera Kiyomi, Kato Shigeharu, Ohtsu Atsushi, Yoshida Shigeaki, Fujii Takahiro
Division of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa-city, Chiba 277-8577, Japan.
World J Gastroenterol. 2006 May 21;12(19):3082-7. doi: 10.3748/wjg.v12.i19.3082.
To investigate the correlation of depressed-type (0-IIc) colorectal neoplasm and family history of first-degree relatives (FDR) with colorectal cancer (CRC).
This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types (0-IIc vs non 0-IIc). Odds ratios (OR) and 95% confidence intervals (CI) were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC.
The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 (95% CI: 1.31-2.61, P = 0.0004), that for non 0-IIc neoplasm was 1.71 (95% CI: 1.22-2.41, P = 0.0017) and for 0-IIc colorectal neoplasm was 2.78 (95% CI: 1.49-5.16, P = 0.0031).
Our study shows a significant association between a family history of FDR with CRC and 0-IIc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy, colonoscopists should check carefully for not only polypoid, but also depressed-type (0-IIc) lesions.
研究凹陷型(0-IIc型)大肠肿瘤与一级亲属(FDR)患结直肠癌(CRC)家族史之间的相关性。
这项横断面研究于2000年6月至2002年10月在国立癌症中心东医院进行。在结肠镜检查前,通过问卷调查对符合条件的接受初次全结肠镜检查的患者就其FDR的CRC家族史进行调查。记录结肠镜检查期间的所有内镜检查结果,并将早期肿瘤/癌症的宏观分类分为两种类型(0-IIc型与非0-IIc型)。通过单因素和多因素逻辑回归计算比值比(OR)和95%置信区间(CI),以估计宏观特征与临床病理数据之间的关联,临床病理数据包括性别、年龄以及FDR患CRC的家族史。
经性别和年龄调整后,FDR患CRC家族史与总体早期肿瘤之间关联的OR为1.85(95%CI:1.31-2.61,P = 0.0004),非0-IIc型肿瘤的OR为1.71(95%CI:1.22-2.41,P = 0.0017),0-IIc型大肠肿瘤的OR为2.78(95%CI:1.49-5.16,P = 0.0031)。
我们的研究表明,FDR患CRC家族史与0-IIc型大肠肿瘤之间存在显著关联。当有FDR患CRC家族史的患者接受结肠镜检查时,结肠镜检查医师不仅应仔细检查息肉样病变,还应仔细检查凹陷型(0-IIc型)病变。