Yamada Atsuo, Watabe Hirotsugu, Iwama Takeo, Obi Shuntaro, Omata Masao, Koike Kazuhiko
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
Fam Cancer. 2014 Mar;13(1):23-8. doi: 10.1007/s10689-013-9668-1.
Familial adenomatous polyposis (FAP) is a genetic disorder in which multiple colorectal polyps and cancers develop. However, the prevalence of small intestinal tumors in patients with FAP remains unclear. We elucidated the prevalence of polyps in the small intestine and duodenum using capsule endoscopy (CE). Patients with FAP receiving a periodic screening colonoscopy at Kyoundo Hospital were encouraged to participate in the study. All study participants underwent esophagogastroduodenoscopy (EGD) within 2 weeks before CE. Outcome measurements were the prevalence of duodenal polyps (DP) and small intestinal polyp (SIP), detectability of the ampulla of Vater, and concordance of the duodenal findings between CE and EGD. Twenty-three patients (mean age, 47 years; 15 males) were enrolled in the study. CE showed DPs in 11 patients (52%) and SIPs in nine patients (43 %). The mean numbers of DPs and SIPs was 11.5 ± 6.2 and 11.9 ± 10.9, respectively. SIPs were more often detected in patients with DPs versus those without (62 vs. 13%, P = 0.07). The ampulla of Vater was observed by CE in four patients (21%). EGD showed DPs in 13 patients (62%). EGD missed DPs in two of 11 patients with DPs detected by CE. EGD found DPs in four of 10 patients without DPs using CE. The kappa index was 0.422. Patients with FAP have a high prevalence of polyps in the small intestine. Although the clinical significance of small intestinal polyps remains unclear, patients with FAP seem to be good candidates for CE.
家族性腺瘤性息肉病（FAP）是一种遗传性疾病，会出现多个结直肠息肉和癌症。然而，FAP患者小肠肿瘤的患病率仍不清楚。我们使用胶囊内镜（CE）阐明了小肠和十二指肠息肉的患病率。鼓励在京畿道医院接受定期结肠镜筛查的FAP患者参与本研究。所有研究参与者在CE前2周内接受了食管胃十二指肠镜检查（EGD）。观察指标为十二指肠息肉（DP）和小肠息肉（SIP）的患病率、Vater壶腹的可检测性以及CE和EGD之间十二指肠检查结果的一致性。23例患者（平均年龄47岁；男性15例）纳入本研究。CE显示11例患者（52%）有DP，9例患者（43%）有SIP。DP和SIP的平均数量分别为11.5±6.2和11.9±10.9。与无DP的患者相比，有DP的患者更常检测到SIP（62%对13%，P=0.07）。4例患者（21%）通过CE观察到Vater壶腹。EGD显示13例患者（62%）有DP。在CE检测到有DP的11例患者中，EGD漏诊了2例。在CE检测无DP的10例患者中，EGD发现4例有DP。kappa指数为0.422。FAP患者小肠息肉患病率较高。虽然小肠息肉的临床意义尚不清楚，但FAP患者似乎是CE的良好候选者。
