Seifert E, Gross U, Schulte F, Stolte M
I. Medizinische Klinik, Städtisches Krankenhaus Kemperhof, Koblenz.
Dtsch Med Wochenschr. 1987 Dec 18;112(51-52):1967-72. doi: 10.1055/s-2008-1068362.
Over a period of six years a total of 407 patients with polyps of the gastrointestinal tract were examined by gastroscopy and coloscopy and the findings analysed retrospectively. Among patients with colon polyps 10.5% were found also to have polypoid gastric lesions, among those with adenoma of the colon the prevalence was 11.7%. Only 2.4% of simultaneously diagnosed gastric lesions were found to be malignant or premalignant, a figure similar to the population average. But in patients with more than ten polyps of the colon both the prevalence of polypoid gastric changes and the significance of polyps with respect to precancerous lesions were clearly increased. On the other hand, in patients with epithelial polyps and/or glandular cysts colon polyps were found in 45%, in 42% with precancerous changes (adenoma). Thus patients with epithelial gastric polyps and glandular cysts probably constitute a group with a real additional risk of colon carcinoma. Regular coloscopy will thus reveal precancerous changes (adenoma) in the colon of 42% of such patients; coloscopic polypectomy will be an effective prophylactic measure against carcinoma of the colon.
在六年的时间里,共有407例胃肠道息肉患者接受了胃镜和结肠镜检查,并对检查结果进行了回顾性分析。在结肠息肉患者中,发现10.5%同时患有息肉样胃部病变,在结肠腺瘤患者中,这一患病率为11.7%。同时诊断出的胃部病变中,只有2.4%被发现为恶性或癌前病变,这一数字与总体平均水平相近。但在结肠息肉超过10个的患者中,息肉样胃部改变的患病率以及息肉对于癌前病变的意义都明显增加。另一方面,在上皮息肉和/或腺囊肿患者中,45%发现有结肠息肉,42%有癌前改变(腺瘤)。因此,患有上皮性胃息肉和腺囊肿的患者可能构成一个真正存在结肠癌额外风险的群体。定期结肠镜检查将因此发现42%此类患者的结肠中有癌前改变(腺瘤);结肠镜息肉切除术将是预防结肠癌的有效措施。