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抗聚集剂给药会导致近端结肠癌的早期诊断吗?

Does antiaggregant administration lead to early diagnosis in proximal colon cancer?

作者信息

Aday Ulas, Gundes Ebubekir, Ciyiltepe Huseyin, Cetin Durmus Ali, Deger Kamuran Cumhur, Gulmez Selcuk, Senger Aziz Serkan, Bozdag Emre

机构信息

Department of Gastroenterology Surgery, Kosuyolu High Speciality Training and Research Hospital, Kartal, Istanbul, Turkey.

出版信息

North Clin Istanb. 2017 Aug 26;4(2):173-179. doi: 10.14744/nci.2017.80148. eCollection 2017.

Abstract

OBJECTIVE

Cancers of the proximal colon are often diagnosed in advanced stages with iron deficiency anemia and nonspecific symptoms. Aspirin and clopidogrel are commonly used antiaggregant agents for various clinical conditions. The aim of this study was to investigate the effects of antiaggregant medication on the early diagnosis of proximal colon cancer.

METHODS

Cases of colon cancer patients who had received curative surgical procedures between January 1, 2013 and July 31, 2016 were retrospectively reviewed. The clinical and pathological results of patients who had used antiaggregant drugs were compared to those who had not.

RESULTS

During the studied period, 246 colorectal cancer patients underwent curative surgical procedures. Of the 67 patients with proximal colon cancer who were included in the study, 27 (40.3%) had taken antiaggregant medication. The mean age of the antiaggregant group was 67.1 years (range: 34-88 years), while it was 58.3 years (range: 34-83 years) for the non-antiaggregant group; the difference between the 2 groups was statistically significant (p=0.03). A pathological evaluation revealed that 74.1% of the antiaggregant group was in the early stages (Stage I/II: 7/13), while 42.5% of the non-antiaggregant group was in the early stages (Stage I/II: 2/15); the difference was statistically significant (p=0.011).

CONCLUSION

Antiaggregant medication has a positive effect on diagnosing proximal colon cancer at early stages. Patients using aspirin or clopidogrel should undergo a complete colonoscopic evaluation in the presence of gastrointestinal tract bleeding or newly developed anemia.

摘要

目的

近端结肠癌通常在晚期伴缺铁性贫血和非特异性症状时才被诊断出来。阿司匹林和氯吡格雷是常用于各种临床情况的抗血小板药物。本研究的目的是探讨抗血小板药物对近端结肠癌早期诊断的影响。

方法

回顾性分析2013年1月1日至2016年7月31日期间接受根治性手术的结肠癌患者病例。将使用抗血小板药物患者的临床和病理结果与未使用抗血小板药物的患者进行比较。

结果

在研究期间,246例结直肠癌患者接受了根治性手术。纳入研究的67例近端结肠癌患者中,27例(40.3%)服用了抗血小板药物。抗血小板药物组的平均年龄为67.1岁(范围:34 - 88岁),而非抗血小板药物组为58.3岁(范围:34 - 83岁);两组之间的差异具有统计学意义(p = 0.03)。病理评估显示,抗血小板药物组74.1%处于早期阶段(I/II期:7/13),而非抗血小板药物组为42.5%(I/II期:2/15);差异具有统计学意义(p = 0.011)。

结论

抗血小板药物对近端结肠癌的早期诊断有积极作用。使用阿司匹林或氯吡格雷的患者在出现胃肠道出血或新发生贫血时应接受完整的结肠镜评估。

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