Resmini Eugenia, Tagliafico Alberto, Bacigalupo Lorenzo, Giordano Giorgia, Melani Enrico, Rebora Alberto, Minuto Francesco, Rollandi Gian Andrea, Ferone Diego
Department of Endocrine and Medical Sciences, University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy.
J Clin Endocrinol Metab. 2009 Jan;94(1):218-22. doi: 10.1210/jc.2008-1479. Epub 2008 Oct 28.
Acromegalic patients have an increased risk for the development of colorectal cancer. For this reason, since 1996, screening colonoscopy has been recommended in all patients with acromegaly. The aim of our study was to assess the feasibility and to evaluate the results of computed tomography (CT)-colonography in acromegaly.
We examined 23 acromegalic patients with no history of colorectal cancer (11 females and 12 males; age range 18-79 yr; disease duration range 1-15 yr) with CT-colonography. Twenty of them underwent traditional colonoscopy after the CT-colonography.
CT-colonography examination results were adequate in 17 of 23 cases (73%). CT-colonography found 12 polyps in eight patients, 95% confirmed by traditional colonoscopy. One polyp was a sigmoid cancer, and the diagnosis was confirmed at surgery. There were no polyps found by traditional colonoscopy that CT-colonography was not able to identify. The lesions were located in right colon (two), transversum (three), left colon (five), and sigmoid colon (two). Patient acceptance of the technique was good in 65%, medium in 20%, and poor in 15%.
For the first time we have demonstrated that CT-colonography has the potential ability to replace traditional colonoscopy in acromegalic patients. CT-colonography could be used as a screening modality for colon cancer in acromegaly.
肢端肥大症患者患结直肠癌的风险增加。因此，自1996年以来，建议对所有肢端肥大症患者进行结肠镜筛查。我们研究的目的是评估计算机断层扫描（CT）结肠成像在肢端肥大症患者中的可行性并评价其结果。
我们对23例无结直肠癌病史的肢端肥大症患者（11例女性和12例男性；年龄范围18 - 79岁；病程范围1 - 15年）进行了CT结肠成像检查。其中20例在CT结肠成像检查后接受了传统结肠镜检查。
23例患者中17例（73%）的CT结肠成像检查结果足够。CT结肠成像在8例患者中发现了12个息肉，95%经传统结肠镜检查证实。1个息肉为乙状结肠癌，手术确诊。传统结肠镜检查未发现CT结肠成像未能识别的息肉。病变位于右半结肠（2个）、横结肠（3个）、左半结肠（5个）和乙状结肠（2个）。65%的患者对该技术接受度良好，20%为中等，15%较差。
我们首次证明CT结肠成像有潜力在肢端肥大症患者中替代传统结肠镜检查。CT结肠成像可作为肢端肥大症患者结肠癌的筛查方式。
