1] Miraca Life Sciences, Irving, Texas, USA [2] Oregon Health & Science University, Portland, Oregon, USA.
1] Miraca Life Sciences, Irving, Texas, USA [2] University of Texas Southwestern Medical Center; Dallas, Texas, USA.
Am J Gastroenterol. 2015 Jul;110(7):1056-61. doi: 10.1038/ajg.2015.130. Epub 2015 Apr 28.
Previous studies have reported a low prevalence of colon polyps in patients with microscopic colitis. The aim of the study was to test whether such inverse associations applied to other inflammatory diseases of the colon.
In a case-control study among 130,204 patients undergoing colonoscopy for the work-up of diarrhea, we compared the prevalence of colon polyps in a case population of patients with inflammatory bowel disease (IBD), microscopic colitis, histologic signs of active colitis, diverticulitis, or ischemic colitis, and in a control population with normal colon mucosa. Case and control subjects were compared using odds ratios and their 95% confidence intervals adjusted for age and sex.
In 11,176 patients with microscopic colitis, the prevalence of hyperplastic polyps, serrated adenomas, and tubular adenomas were all reduced: odds ratios=0.46 (95% confidence intervals=0.43-0.49), 0.24 (0.19-0.30), and 0.35 (0.33-0.38), respectively. In 4,435 patients with IBD, the corresponding values were: 0.18 (0.15-0.21), 0.24 (0.16-0.35), and 0.18 (0.15-0.21), respectively. In 6,501 patients with histologically active colitis, the corresponding values were: 0.58 (0.53-0.63), 0.57 (0.46-0.70), and 0.63 (0.58-0.68), respectively. No such consistent reduction in polyp prevalence was found in patients with diverticulitis or ischemic colitis.
Chronic inflammatory conditions of the colon are associated with a decreased prevalence of colon polyps.
先前的研究报告称显微镜结肠炎患者的结肠息肉患病率较低。本研究旨在检验这种相反的关联是否适用于结肠的其他炎症性疾病。
在一项纳入 130204 例行结肠镜检查以明确腹泻病因的患者的病例对照研究中，我们比较了炎症性肠病（IBD）、显微镜结肠炎、组织学活动性结肠炎、憩室炎或缺血性结肠炎患者的病例人群和结肠黏膜正常的对照组人群中结肠息肉的患病率。采用比值比及其 95%置信区间比较病例组和对照组，调整年龄和性别因素。
在 11176 例显微镜结肠炎患者中，增生性息肉、锯齿状腺瘤和管状腺瘤的患病率均降低：比值比分别为 0.46（95%置信区间 0.43-0.49）、0.24（0.19-0.30）和 0.35（0.33-0.38）。在 4435 例 IBD 患者中，相应值分别为 0.18（0.15-0.21）、0.24（0.16-0.35）和 0.18（0.15-0.21）。在 6501 例组织学活动性结肠炎患者中，相应值分别为 0.58（0.53-0.63）、0.57（0.46-0.70）和 0.63（0.58-0.68）。在憩室炎或缺血性结肠炎患者中，未发现息肉患病率有这种一致的降低。
结肠的慢性炎症性疾病与结肠息肉患病率降低相关。
