Ateş Öztürk, Sivri Bülent, Kılıçkap Saadettin
Turk J Med Sci. 2017 Nov 13;47(5):1370-1376. doi: 10.3906/sag-1601-63.
Background/aim: Colorectal adenomatous polyps are precursors of colorectal cancer (CRC), which can be prevented with surveillance colonoscopy. This study aimed to assess risk factors for the recurrence of colorectal polyps and CRC following polypectomy. Materials and methods: In this single-center trial, a total of 510 patients who applied to the endoscopy unit of Hacettepe University Hospital for various reasons and who were diagnosed with at least one colorectal adenomatous polyp between 2000 and 2010 were retrospectively analyzed. Patients with colorectal adenomatous polyps or CRC recurrences were examined in terms of clinical and histological risk factors. Results: A total of 190 (37.1%) patients had surveillance colonoscopy. Among them, 127 (66.3%) were found to have polyp recurrence. Of the parameters defined for polyp recurrence, no association was found between the number of polyps (1-2, ≥3) (1-3, ≥4) in the first colonoscopy and diabetes mellitus, hypertension, hyperlipidemia, sex, family history of colon malignancy, smoking, alcohol usage, size of polyp (<10 mm, ≥10 mm), or advanced histologic type of polyp. The only significant difference was observed in patients who had left-sided colon polyps. In the basal colonoscopy, 130 patients had been diagnosed with CRC, and a significant correlation was found between the number of polyps (1, ≥2) and polyp size (≥10 mm), anemia, high sedimentation rate (>25), and CRC. In the first surveillance colonoscopy, CRC was detected in 12 patients. There was a significant correlation between the development of CRC and advanced histological type, anemia with high erythrocyte sedimentation rate, polyp size (<10 mm, ≥10 mm), and the number of polyps (<3, ≥3). Conclusion: Patients with left-sided colon polyps had a high risk of developing colorectal polyp recurrence. Moreover, the risk of developing CRC increased in patients who had advanced histology, a polyp larger than 10 mm, or more than three polyps.
背景/目的：结直肠腺瘤性息肉是结直肠癌（CRC）的前体，可通过监测结肠镜检查预防。本研究旨在评估息肉切除术后结直肠息肉和CRC复发的危险因素。材料与方法：在这项单中心试验中，对2000年至2010年间因各种原因到哈杰泰佩大学医院内镜科就诊且被诊断患有至少一个结直肠腺瘤性息肉的510例患者进行了回顾性分析。对结直肠腺瘤性息肉或CRC复发患者的临床和组织学危险因素进行了检查。结果：共有190例（37.1%）患者接受了监测结肠镜检查。其中，127例（66.3%）发现有息肉复发。在为息肉复发定义的参数中，首次结肠镜检查时息肉数量（1 - 2个，≥3个）（1 - 3个，≥4个）与糖尿病、高血压、高脂血症、性别、结肠恶性肿瘤家族史、吸烟、饮酒、息肉大小（<10 mm，≥10 mm）或息肉的高级组织学类型之间均未发现关联。唯一显著差异见于左侧结肠息肉患者。在基础结肠镜检查中，130例患者被诊断患有CRC，息肉数量（1个，≥2个）、息肉大小（≥10 mm）、贫血、高血沉率（>25）与CRC之间存在显著相关性。在首次监测结肠镜检查中，12例患者检测到CRC。CRC的发生与高级组织学类型、高红细胞沉降率的贫血、息肉大小（<10 mm，≥10 mm）以及息肉数量（<3个，≥3个）之间存在显著相关性。结论：左侧结肠息肉患者发生结直肠息肉复发的风险较高。此外，组织学高级别、息肉大于10 mm或息肉超过三个的患者发生CRC的风险增加。
