Lin Xian-Feng, Shi Ke-Qing, You Jie, Liu Wen-Yue, Luo Ying-Wan, Wu Fa-Ling, Chen Yong-Ping, Wong Danny Ka-Ho, Yuen Man-Fung, Zheng Ming-Hua
Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou, 325000, China.
Mol Biol Rep. 2014 May;41(5):2989-97. doi: 10.1007/s11033-014-3157-y. Epub 2014 Jan 22.
Nonalcoholic fatty liver disease (NAFLD) has been suggested to be a strong risk factor of colorectal benign adenomas and advanced neoplasms. The aim of this large cohort study was to further investigate the prevalence of colorectal malignant neoplasm (CRMN) in patients with NAFLD and determine whether association between NAFLD and CRMN exists. 2,315 community subjects (1,370 males and 945 females) who underwent a routine colonoscopy according to international colorectal cancer screening guideline were recruited. Nature of colorectal lesions determined by biopsy and NAFLD was diagnosed by ultrasound. Binary logistic regression analysis was applied to explore the related associations. Prevalence of CRMN was 29.3% (77/263) in patients with NAFLD, which was significantly higher than 18.0% (369/2,052) in the control group (P<0.05). In addition, malignant neoplasm in NAFLD group occurred more frequently at sigmoid colon than in control group (14.3 vs. 11.9%). The incidence of highly-differentiated colorectal adenocarcinoma in NAFLD group was significantly higher than control group (62.3 vs. 9.8%). Univariate analysis showed that NAFLD had strong association with CRMN (OR 2.043; 95% CI 1.512-2.761; P<0.05). After adjusting for metabolic and other confounding factors, NAFLD remained as an independent risk factor for CRMN (OR 1.868; 95% CI 1.360-2.567; P<0.05). NAFLD was an independent risk factor for CRMN. Sigmoid carcinoma and highly differentiated colorectal adenocarcinoma were more commonly found in NAFLD. (ClinicalTrials.gov number, NCT01657773, website: http://clinicaltrials.gov/ct2/show/NCT01657773?term=zheng+minghua&rank=1 ).
非酒精性脂肪性肝病（NAFLD）被认为是结直肠良性腺瘤和晚期肿瘤的一个重要危险因素。这项大型队列研究的目的是进一步调查NAFLD患者中结直肠恶性肿瘤（CRMN）的患病率，并确定NAFLD与CRMN之间是否存在关联。根据国际结直肠癌筛查指南，招募了2315名接受常规结肠镜检查的社区受试者（1370名男性和945名女性）。通过活检确定结直肠病变的性质，通过超声诊断NAFLD。应用二元逻辑回归分析来探讨相关关联。NAFLD患者中CRMN的患病率为29.3%（77/263），显著高于对照组的18.0%（369/2052）（P<0.05）。此外，NAFLD组的恶性肿瘤在乙状结肠的发生率高于对照组（14.3%对11.9%）。NAFLD组高分化结直肠腺癌的发生率显著高于对照组（62.3%对9.8%）。单因素分析显示，NAFLD与CRMN有很强的关联（OR 2.043；95%CI 1.512 - 2.761；P<0.05）。在调整代谢和其他混杂因素后，NAFLD仍然是CRMN的独立危险因素（OR
