Suchanek Stepan, Grega Tomas, Ngo Ondrej, Vojtechova Gabriela, Majek Ondrej, Minarikova Petra, Brogyuk Nagyija, Bunganic Bohus, Seifert Bohumil, Dusek Ladislav, Zavoral Miroslav
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
World J Gastroenterol. 2016 Sep 28;22(36):8103-11. doi: 10.3748/wjg.v22.i36.8103.
The incidence and prevalence of metabolic syndrome (MS) and colorectal cancer (CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence is available about the relationship between MS and CRC precancerous lesions (adenomatous polyps, adenomas). The aim of this paper is to present an overview of our scientific understanding of that topic and its implication in clinical practice. One of the principal goals of current CRC secondary prevention efforts is to detect and remove the precancerous lesions in individuals with an average CRC risk to prevent the development of invasive cancer. MS is not currently considered a high-risk CRC factor and is therefore not included in the guidelines of organized screening programs. However, in light of growing scientific evidence, the approach to patients with MS should be changed. Metabolic risk factors for the development of adenomas and cancers are the same - obesity, impaired glucose tolerance, dyslipidemia, hypertension, cardiovascular diseases and diabetes mellitus type 2. Therefore, the key issue in the near future is the development of a simple scoring system, easy to use in clinical practice, which would identify individuals with high metabolic risk of colorectal neoplasia and would be used for individual CRC secondary prevention strategies. Currently, such scoring systems have been published based on Asian (Asia-Pacific Colorectal Screening Score; APCS) and Polish populations.
在发达国家，代谢综合征（MS）和结直肠癌（CRC）的发病率及患病率一直在上升。这两种疾病之间的关联已得到广泛研究和报道。关于MS与CRC癌前病变（腺瘤性息肉、腺瘤）之间关系的证据较少。本文旨在概述我们对该主题的科学认识及其在临床实践中的意义。当前CRC二级预防工作的主要目标之一是在平均CRC风险个体中检测并切除癌前病变，以预防浸润性癌症的发生。MS目前不被视为CRC的高危因素，因此未被纳入有组织筛查项目的指南中。然而，鉴于越来越多的科学证据，对MS患者的处理方式应有所改变。腺瘤和癌症发生的代谢危险因素是相同的——肥胖、糖耐量受损、血脂异常、高血压、心血管疾病和2型糖尿病。因此，近期的关键问题是开发一种简单的评分系统，便于在临床实践中使用，该系统能够识别具有高代谢风险的结直肠肿瘤个体，并用于个体CRC二级预防策略。目前，基于亚洲人群（亚太结直肠癌筛查评分；APCS）和波兰人群已经发表了这样的评分系统。
