Ko Sun-Hye, Baeg Myong Ki, Bae Woong Jin, Kim Pumsoo, Choi Myung-Gyu
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, International St Mary's Hospital, Catholic Kwandong University, Incheon, South Korea.
Onco Targets Ther. 2016 Sep 9;9:5611-7. doi: 10.2147/OTT.S110595. eCollection 2016.
BACKGROUND/AIMS: Patients being treated for prostate cancer (PCa) have an increased risk of developing colorectal cancer. However, whether PCa patients are inherently at a higher risk of colorectal neoplasms (CRNs) is unknown. We aimed to investigate the risk of CRNs in PCa patients.
Patients who had been diagnosed with PCa at a tertiary medical center and had colonoscopy within 1 year of the PCa diagnosis were investigated. Patients were propensity-matched 1:2 by age and body mass index to asymptomatic control subjects who had undergone colonoscopy for routine health screening. CRN was defined as histological confirmation of an adenoma or adenocarcinoma component. Advanced CRN was defined as any of the following: 1) histological findings of high-grade dysplasia, 2) inclusion of villous features, 3) tumor ≥1 cm in size, or 4) presence of an adenocarcinoma. Risk factors for CRN and advanced CRN were evaluated by univariate and multivariate analysis.
A total of 191 patients diagnosed with PCa had colonoscopies within 1 year of PCa diagnosis. Of these, 23 patients with a history of previous malignancy and seven with incomplete colonoscopies were excluded, leaving 161 patients in the PCa group. Although presence of PCa was not a significant risk factor for CRN by multivariate analysis, PCa was a significant risk factor for advanced CRN (odds ratio [OR] 3.300; 95% confidence interval [CI] 1.766-6.167; P<0.001). Other significant risk factors for advanced CRN were age (OR 1.050; 95% CI 1.003-1.009; P=0.036) and body mass index (OR 1.205; 95% CI 1.067-1.361; P=0.003), whereas aspirin use (OR 0.414; 95% CI 0.173-0.990; P=0.047) was a preventive factor.
The risk of advanced CRN may be significantly increased in patients with PCa. Patients with PCa should have a colonoscopy at the time of PCa diagnosis.
背景/目的：接受前列腺癌（PCa）治疗的患者患结直肠癌的风险增加。然而，PCa患者是否本身患结直肠肿瘤（CRN）的风险更高尚不清楚。我们旨在调查PCa患者发生CRN的风险。
对在一家三级医疗中心被诊断为PCa且在PCa诊断后1年内接受结肠镜检查的患者进行调查。根据年龄和体重指数将患者与因常规健康筛查接受结肠镜检查的无症状对照受试者按1:2进行倾向评分匹配。CRN定义为腺瘤或腺癌成分的组织学确认。进展期CRN定义为以下任何一种情况：1）高级别异型增生的组织学表现，2）包含绒毛特征，3）肿瘤大小≥1 cm，或4）存在腺癌。通过单因素和多因素分析评估CRN和进展期CRN的危险因素。
共有191例被诊断为PCa的患者在PCa诊断后1年内接受了结肠镜检查。其中，排除23例有既往恶性肿瘤病史的患者和7例结肠镜检查不完整的患者，PCa组剩余161例患者。虽然多因素分析显示PCa的存在不是CRN的显著危险因素，但PCa是进展期CRN的显著危险因素（比值比[OR] 3.300；95%置信区间[CI] 1.766 - 6.167；P<0.001）。进展期CRN的其他显著危险因素是年龄（OR 1.050；95% CI 1.003 - 1.009；P = 0.036）和体重指数（OR 1.205；95% CI 1.067 - 1.361；P = 0.003），而使用阿司匹林（OR 0.414；95% CI 0.173 - 0.990；P = 0.047）是一个预防因素。
PCa患者进展期CRN的风险可能显著增加。PCa患者应在PCa诊断时进行结肠镜检查。
