Alfonso-Moreno Vicente, López-Serrano Antonio, Moreno-Osset Eduardo
Medicina Digestiva, Hospital Dr. Peset, España.
Rev Esp Enferm Dig. 2017 Dec;109(12):875. doi: 10.17235/reed.2017.5178/2017.
Chemoprevention is a practical approach to reduce the risk of various cancers including colorectal cancer (CRC). The goal is to reduce the incidence of pre-neoplastic adenomatous polyps and prevent its progression to CRC. Curcumin and silibinin prevent intestinal polyp formation in mice. Curcumin sensitizes silymarin to exert synergistic anticancer activity in colon cancer cells. Patients presenting with multiple colorectal adenomatous polyps (MCRA) have a high lifetime risk for CRC. We present a 57-year-old man with MCRA, without deleterious germline APC or MYH mutations. Our patient had 54 polyps in the first colonoscopy, most of 3 to 8 mm and one of 20 mm with high grade dysplasia / adenocarcinoma. Four subsequent colonoscopies showed continuous development of adenomatous polyps treated by polypectomy for the most part and some with heat. After the treatment with curcumin for 3 months and a half followed by silibinin for 9 months, we find many less polyps than in the previous colonoscopies, going from the finding of 40 adenomas of 3-6 mm in the pre-treatment colonoscopy to 3 polyps after treatment.
化学预防是一种降低包括结直肠癌（CRC）在内的各种癌症风险的实用方法。其目标是降低癌前腺瘤性息肉的发生率，并防止其发展为结直肠癌。姜黄素和水飞蓟宾可预防小鼠肠道息肉的形成。姜黄素可使水飞蓟素在结肠癌细胞中发挥协同抗癌活性。患有多发性结直肠腺瘤性息肉（MCRA）的患者患结直肠癌的终生风险很高。我们报告一名57岁患有MCRA的男性，其种系APC或MYH基因无有害突变。我们的患者在首次结肠镜检查时有54个息肉，大多数为3至8毫米，其中一个为20毫米，伴有高级别异型增生/腺癌。随后的四次结肠镜检查显示腺瘤性息肉持续发展，大部分通过息肉切除术治疗，有些采用热凝治疗。在用姜黄素治疗3个半月后接着用水飞蓟宾治疗9个月后，我们发现息肉比之前的结肠镜检查时少了很多，从治疗前结肠镜检查发现40个3 - 6毫米的腺瘤，到治疗后变为3个息肉。
