Digestive Endoscopy Unit;Institute of Public Health, Section of Hygiene, Catholic University; Rome, Italy.
Digestive and Liver Disease Unit, S. Andrea Hospital, Sapienza University of Rome , Rome, Italy.
J Gastrointestin Liver Dis. 2015 Dec;24(4):445-50. doi: 10.15403/jgld.2014.1121.244.rsk.
It has been reported that patients with intraductal papillary mucinous neoplasms of the pancreas are at an increased risk of colorectal cancer. The aim of our study was to investigate whether patients with intraductal papillary mucinous neoplasms are at a higher risk of colorectal adenomas with respect to the general population, as this condition represents the precursor of sporadic colorectal cancer.
A case-control study was conducted at the Catholic University and University Sapienza, Rome, Italy. The cases were patients with intraductal papillary mucinous neoplasms without history of colorectal cancer, who had underwent screening colonoscopy for the first time. The controls were individuals who had underwent first time colonoscopy for screening or evaluation of non-specific abdominal symptoms. Chi-square and Fisher tests were used to compare the distributions of categorical variables.
We enrolled 122 cases and 246 controls. Colorectal polyps were found in 52 cases (42.6%) and 79 controls (32.1%) (p<0.05). In 29 cases (23.8%) and 57 controls (23.2%) histological examination disclosed adenomatous polyps (p=0.90). There was no difference between the groups in relation to the presence of polyps with low-grade (19.7% vs. 19.8%, p=0.98) and high-grade dysplasia (4.9% vs. 4.5%, p=0.85).
Patients with intraductal papillary mucinous neoplasms of the pancreas are not at an increased risk for the development of adenomatous colorectal polyps.
已有报道称胰腺内导管乳头状黏液性肿瘤患者发生结直肠癌的风险增加。本研究旨在探讨胰腺内导管乳头状黏液性肿瘤患者发生结直肠腺瘤的风险是否高于普通人群，因为这种情况代表散发性结直肠癌的前期病变。
本研究在意大利罗马天主教大学和罗马 Sapienza 大学进行了一项病例对照研究。病例为首次接受筛查性结肠镜检查、无结直肠癌病史的胰腺内导管乳头状黏液性肿瘤患者。对照组为首次因筛查或非特异性腹部症状行结肠镜检查的个体。采用卡方检验和 Fisher 确切概率法比较分类变量的分布。
共纳入 122 例病例和 246 例对照。52 例（42.6%）病例和 79 例（32.1%）对照发现结直肠息肉（p<0.05）。29 例（23.8%）病例和 57 例（23.2%）对照的组织学检查显示存在腺瘤性息肉（p=0.90）。两组在低级别（19.7% vs. 19.8%，p=0.98）和高级别（4.9% vs. 4.5%，p=0.85）异型增生息肉的存在方面无差异。
胰腺内导管乳头状黏液性肿瘤患者发生结直肠腺瘤性息肉的风险并未增加。
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