Bechtler M, Eickhoff A, Riemann J F
Medizinische Klinik C, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen.
Dtsch Med Wochenschr. 2008 Nov;133(47):2458-62. doi: 10.1055/s-0028-1100939. Epub 2008 Nov 12.
Colorectal cancer that occurs during an interval between screening colonoscopies is called "interval carcinoma". These cancers are more frequent than would be expected, diagnosed in about tow per thousand patient years. There are three main causes for interval carcinomas: 50 % result from failed detection of polyps during colonoscopy, 25 % are tumors that develop during the screening interval and 25 % result from incomplete polypectomy. Knowing these etiologies screening makes it possible to optimize treatment. Colonoscopy of the highest quality is essential for providing reliable screening. Risk stratification during the first colonoscopy allows for optimal timing of follow-up-examinations. Difficult polypectomies require frequent follow-ups. Serrated adenomas should be treated like adenomas. Interval carcinomas are often detected during screening at an early stage: colonoscopy screening can save life of these patients.
在结肠镜筛查间隔期发生的结直肠癌被称为“间隔期癌”。这些癌症比预期更为常见,每千患者年中约有两例被诊断出来。间隔期癌主要有三个原因:50%是由于结肠镜检查时息肉未被检测到,25%是在筛查间隔期发生的肿瘤,25%是息肉切除不完全导致的。了解这些病因有助于优化治疗。高质量的结肠镜检查对于提供可靠的筛查至关重要。首次结肠镜检查时进行风险分层有助于确定最佳的随访检查时间。困难的息肉切除术需要频繁随访。锯齿状腺瘤应像腺瘤一样治疗。间隔期癌常在筛查早期被发现:结肠镜筛查可以挽救这些患者的生命。