手术治疗胃癌患者中结直肠同步肿瘤的发生率及结肠镜筛查的意义。
Prevalence of synchronous colorectal neoplasms in surgically treated gastric cancer patients and significance of screening colonoscopy.
机构信息
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
出版信息
Dig Endosc. 2014 May;26(3):396-402. doi: 10.1111/den.12156. Epub 2013 Aug 23.
BACKGROUND AND AIM
The existence of other primary tumors during the treatment and management of gastric cancer (GC) is an important issue. The present study investigated the prevalence and management of synchronous colorectal neoplasms (CRN) in surgically treated GC patients.
METHODS
Of 381 surgically treated GC patients, 332 (87.1%) underwent colonoscopy to detect CRN before surgery or within a year after surgery.
RESULTS
CRN were synchronously observed in 140 patients (42.2%). Adenoma was observed in 131 patients (39.4%). Endoscopic resection was done in 18 patients with adenoma. Colorectal cancer (CRC) was observed in 16 patients (4.8%), superficial CRC in 13 and advanced CRC in three patients. Endoscopic resection of superficial CRC was carried out in seven patients, whereas simultaneous surgical resection of CRC was done in nine patients. CRN were more frequently observed in men. CRC was more frequently observed in GC patients with distant metastasis, albeit without significance. The overall survival of GC patients with CRN or CRC was poorer than that of patients without CRN or CRC.
CONCLUSION
Synchronous CRN were commonly associated with GC and screening colonoscopy should be offered to patients with GC.
背景与目的
在胃癌（GC）的治疗和管理过程中存在其他原发性肿瘤是一个重要问题。本研究调查了手术治疗 GC 患者中同时发生的结直肠肿瘤（CRN）的患病率和处理情况。
方法
对 381 例接受手术治疗的 GC 患者进行了研究，其中 332 例（87.1%）在手术前或手术后 1 年内接受了结肠镜检查以检测 CRN。
结果
在 140 例患者（42.2%）中同时观察到了 CRN。在 131 例患者中观察到了腺瘤。18 例腺瘤患者接受了内镜下切除术。在 16 例患者中观察到了结直肠癌（CRC），其中 13 例为浅表 CRC，3 例为进展期 CRC。对 7 例浅表 CRC 患者进行了内镜下切除，对 9 例 CRC 患者同时进行了手术切除。CRN 更常见于男性。CRC 在有远处转移的 GC 患者中更为常见，但无统计学意义。有 CRN 或 CRC 的 GC 患者的总体生存率低于无 CRN 或 CRC 的患者。
结论
同时发生的 CRN 与 GC 密切相关，应向 GC 患者提供筛查结肠镜检查。
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