结直肠息肉切除术与按亚部位划分的结直肠癌风险：福冈结直肠癌研究

Colorectal polypectomy and risk of colorectal cancer by subsite: the Fukuoka Colorectal Cancer study.

作者信息

Yoshida Daigo, Kono Suminori, Moore Malcolm A, Toyomura Kengo, Nagano Jun, Mizoue Tetsuya, Mibu Ryuichi, Tanaka Masao, Kakeji Yoshihiro, Maehara Yoshihiko, Okamura Takeshi, Ikejiri Koji, Futami Kitaroh, Yasunami Yohichi, Maekawa Takafumi, Takenaka Kenji, Ichimiya Hitoshi, Imaizumi Nobutoshi

机构信息

Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Jpn J Clin Oncol. 2007 Aug;37(8):597-602. doi: 10.1093/jjco/hym065. Epub 2007 Aug 23.

DOI:10.1093/jjco/hym065

PMID:17716994

Abstract

BACKGROUND

Colorectal adenomas are well-established precursor lesions for colorectal cancer and removal of polyps is deemed to reduce the risk of colorectal cancer. However, benefit of colorectal polypectomy in routine practice is still uncertain. We therefore investigated subsite-specific risks of colorectal cancer in relation to history of colorectal polypectomy in a case-control study.

METHODS

Both case patients and control subjects were residents aged 20-74 years in Fukuoka City and three adjacent areas. The case group comprised 840 patients undergoing surgery for a first diagnosis of colorectal cancer, while the control subjects were 833 residents who were selected in the community by two-stage random sampling. Past history of selected diseases, surgery and lifestyle factors were ascertained by in-person interview. Statistical adjustment was made for sex, 5-year age class, residence, smoking, alcohol drinking, physical activity, body mass index and parental history of colorectal cancer.

RESULTS

Overall, 74 case patients (9%) and 85 control subjects (10%) reported a prior history of colorectal polyps, and 50 cases (6%) and 64 controls (8%) had a history of colorectal polypectomy. The adjusted odds ratio associated with colorectal polypectomy was 0.71 (95% confidence interval [CI] 0.48-1.06) for the overall risk of colorectal cancer. The corresponding values for cancer of the proximal colon, distal colon, and rectum were 1.68 (95% CI 0.98-2.88), 0.71 (95% CI 0.41-1.26) and 0.24 (95% CI 0.11-0.52), respectively.

CONCLUSIONS

The findings indicate that colorectal polypectomy in current practice confers a decreased risk of rectal cancer and possibly of distal colon cancer.

摘要

背景

结直肠腺瘤是公认的结直肠癌前体病变，切除息肉被认为可降低结直肠癌风险。然而，结直肠息肉切除术在常规实践中的益处仍不明确。因此，我们在一项病例对照研究中调查了结直肠息肉切除史与结直肠癌各亚部位特异性风险的关系。

方法

病例组和对照组均为福冈市及三个相邻地区20 - 74岁的居民。病例组包括840例首次诊断为结直肠癌并接受手术的患者，而对照组是通过两阶段随机抽样在社区中选取的833名居民。通过面对面访谈确定所选疾病、手术史和生活方式因素。对性别、5岁年龄组、居住地、吸烟、饮酒、身体活动、体重指数和结直肠癌家族史进行了统计调整。

结果

总体而言，74例病例患者（9%）和85名对照者（10%）报告有结直肠息肉病史，50例病例（6%）和64名对照者（8%）有结直肠息肉切除史。结直肠息肉切除术相关的调整后比值比，对于结直肠癌总体风险为0.71（95%置信区间[CI] 0.48 - 1.06）。近端结肠癌、远端结肠癌和直肠癌的相应值分别为1.68（95% CI 0.98 - 2.88）、0.71（95% CI 0.41 - 1.26）和0.24（95% CI 0.11 - 0.52）。