Krzentowska Anna, Gołkowski Filip, Bałdys-Waligórska Agata, Hubalewska-Dydejczyk Alicja
Katedra i Klinika Endokrynologii, Uniwersytet Jagielloński, Collegium Medicum, Kraków.
Przegl Lek. 2010;67(12):1266-9.
Acromegaly is a rare, chronic disease due to hypersecretion of growth hormone (GH) by pituitary adenoma arising from somatotrophs. The course of the disease is related to long-term organ and systemic complications and malignancies. Colon polyps seem to constitute the most frequent tumours in acromegaly apart from thyroid nodules. The aim of this study was to evaluate the prevalence of colon polyps in patients with acromegaly. Thirty one acromegaly patients, 22 females and 9 males (mean age 46.3 +/- 11.9 yrs), were enrolled to the study. Colonoscopy with histopathological assessment of specimens taken during examination was carried out in all patients. Colon polyps were found in 13 patients (41.9%) i.e. 8 females and 5 males. In two patients multiple polyps were discovered (2 and 3 respectively). Polyps were histopatologically verified as tubular adenoma with low-grade dysplasia (10 patients, 76.9%) and hyperplastic polyps (3 patients, 23.1%). The prevalence of colon polyps was significantly related to the duration of uncontrolled acromegaly (p < 0.01). Median duration of uncontrolled acromegaly in patients with and without colon polyps were 10.0 (IQR = 2.0) yrs and 6.5 (IQR = 5.0) yrs, respectively. IGF-1, GH basic and in 120 min of OGTT serum concentrations on diagnosis were not significantly related to the prevalence of colon polyps. Our study indicates that duration of uncontrolled acromegaly, contrary to IGF-1, GH basic and in OGTT serum concentrations at diagnosis are essential for the colon polyps development. Colonoscopy is considered to be routine in patients with acromegaly.
肢端肥大症是一种罕见的慢性疾病,由生长激素细胞来源的垂体腺瘤分泌过多生长激素(GH)所致。该病的病程与长期的器官和全身并发症及恶性肿瘤相关。除甲状腺结节外,结肠息肉似乎是肢端肥大症患者中最常见的肿瘤。本研究的目的是评估肢端肥大症患者结肠息肉的患病率。31例肢端肥大症患者纳入研究,其中女性22例,男性9例(平均年龄46.3±11.9岁)。所有患者均接受结肠镜检查,并对检查期间采集的标本进行组织病理学评估。13例患者(41.9%)发现结肠息肉,其中女性8例,男性5例。2例患者发现多个息肉(分别为2个和3个)。息肉经组织病理学证实为低级别异型增生的管状腺瘤(10例,76.9%)和增生性息肉(3例,23.1%)。结肠息肉的患病率与肢端肥大症未得到控制的持续时间显著相关(p<0.01)。有结肠息肉和无结肠息肉患者肢端肥大症未得到控制的中位持续时间分别为10.0(四分位间距=2.0)年和6.5(四分位间距=5.0)年。诊断时IGF-1、基础GH以及口服葡萄糖耐量试验(OGTT)120分钟时的血清浓度与结肠息肉的患病率无显著相关性。我们的研究表明,与IGF-1、基础GH以及诊断时OGTT血清浓度相反,肢端肥大症未得到控制的持续时间对结肠息肉的发生至关重要。结肠镜检查被认为是肢端肥大症患者的常规检查。