Yamamoto Masaaki, Fukuoka Hidenori, Iguchi Genzo, Matsumoto Ryusaku, Takahashi Michiko, Nishizawa Hitoshi, Suda Kentaro, Bando Hironori, Takahashi Yutaka
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Pituitary. 2015 Jun;18(3):343-51. doi: 10.1007/s11102-014-0580-y.
Colorectal neoplasms are well known to be a complication in cases of acromegaly; however, data on the prevalence of colorectal neoplasms in Asian patients with acromegaly are limited. Further, the factors associated with colorectal neoplasms in cases of acromegaly are controversial. Therefore, we aimed to clarify the prevalence of and factors associated with colorectal neoplasms in Japanese patients with acromegaly in a single center.
We analyzed consecutive 57 patients who had undergone full-length colonoscopy at the time of diagnosis at Kobe University Hospital between 1986 and 2012.
Of the 57 patients, 22 (38.6%), 18 (31.6%) and 3 (5.3%) patients were diagnosed with hyperplastic polyps, adenomas, and adenocarcinomas, respectively and the prevalence was significantly higher than in a historical control group, Chinese patients with irritable bowel syndrome (The odds ratio was 4.0, 8.7, and 17.5, respectively). The prevalence of adenocarcinomas was also significantly higher in these patients than in the general Japanese population (odds ratio 14.5). Patients with acromegaly who had colorectal neoplasms had longer disease duration than those without colorectal neoplasms. Of note, the area under the growth hormone (GH) concentration-time curve (GH AUC) during the oral glucose tolerance test was significantly higher in patients with adenocarcinomas than in those with no colonic lesion or those with hyperplastic polyps.
Japanese patients with acromegaly exhibited an increased risk of colorectal neoplasms, especially colorectal adenocarcinomas. An increased GH AUC was associated with an increased risk for colon adenocarcinomas in patients with acromegaly.
众所周知，结直肠肿瘤是肢端肥大症患者的一种并发症；然而，关于亚洲肢端肥大症患者结直肠肿瘤患病率的数据有限。此外，肢端肥大症患者中与结直肠肿瘤相关的因素存在争议。因此，我们旨在阐明日本单中心肢端肥大症患者结直肠肿瘤的患病率及相关因素。
我们分析了1986年至2012年间在神户大学医院确诊时接受全结肠镜检查的57例连续病例。
57例患者中，分别有22例（38.6%）、18例（31.6%）和3例（5.3%）被诊断为增生性息肉、腺瘤和腺癌，其患病率显著高于历史对照组——中国肠易激综合征患者（优势比分别为4.0、8.7和17.5）。这些患者中腺癌的患病率也显著高于日本普通人群（优势比14.5）。患有结直肠肿瘤的肢端肥大症患者的病程比未患结直肠肿瘤的患者更长。值得注意的是，口服葡萄糖耐量试验期间生长激素（GH）浓度-时间曲线下面积（GH AUC）在腺癌患者中显著高于无结肠病变或增生性息肉的患者。
日本肢端肥大症患者结直肠肿瘤尤其是结直肠腺癌的风险增加。GH AUC升高与肢端肥大症患者结肠腺癌风险增加相关。
