Lasa J, Rausch A, Zubiaurre I
Departamento de Gastroenterología, Hospital Británico, Buenos Aires, Argentina.
Departamento de Gastroenterología, Hospital Británico, Buenos Aires, Argentina.
Rev Gastroenterol Mex (Engl Ed). 2018 Apr-Jun;83(2):91-97. doi: 10.1016/j.rgmx.2017.05.007. Epub 2018 Feb 13.
Whether celiac disease increases the risk of presenting with colorectal adenoma or not, has not been extensively evaluated. This question becomes relevant when considering early screening methods in patients with the disease. The aim of our article was to determine the risk of colorectal adenomas in celiac disease patients.
A computer-assisted search of the MEDLINE-Pubmed, EMBASE, LILACS, Cochrane Library, and Google Scholar databases was carried out, encompassing the time frame of 1966 to December 2016. The search strategy consisted of the following MESH terms: 'celiac disease' OR 'celiac sprue' AND 'colorectal' OR 'colorectal neoplasia' OR 'colorectal adenoma'. A fixed-effect model was used for the analyses. The first analysis dealt with the prevalence of all presentations of colorectal adenoma in patients with celiac disease and the second was on the prevalence of advanced adenomas. The outcomes were described as odds ratios (OR) with their 95% confidence intervals.
The search identified 480 bibliographic citations, 17 of which were chosen for evaluation. Fourteen of those studies were rejected, leaving a final total of three for the analysis. Those studies included 367 cases of celiac disease and 682 controls. No significant heterogeneity was observed (I=26%). There was no increased prevalence of colorectal adenomas in the celiac disease patients, when compared with the controls (OR: 0.94 [0.65-1.38]), and no significant difference was observed when assessing the prevalence of advanced adenomas (OR: 0.97 [0.48-1.97]).
Celiac disease was not associated with an increased risk of colorectal adenomas. However, due to the limited evidence available, more studies are necessary to determine whether there is an actual association.
乳糜泻是否会增加患结直肠腺瘤的风险，尚未得到广泛评估。在考虑对该病患者进行早期筛查方法时，这个问题变得至关重要。我们文章的目的是确定乳糜泻患者患结直肠腺瘤的风险。
对MEDLINE-Pubmed、EMBASE、LILACS、Cochrane图书馆和谷歌学术数据库进行了计算机辅助检索，检索时间范围为1966年至2016年12月。检索策略包括以下医学主题词：“乳糜泻”或“口炎性腹泻”以及“结肠直肠”或“结直肠肿瘤”或“结直肠腺瘤”。分析采用固定效应模型。第一次分析涉及乳糜泻患者中所有结直肠腺瘤表现的患病率，第二次分析是关于高级别腺瘤的患病率。结果以比值比（OR）及其95%置信区间表示。
检索共识别出480条文献引用，其中17条被选作评估。这些研究中有14条被排除，最终共有3条纳入分析。这些研究包括367例乳糜泻患者和682例对照。未观察到显著的异质性（I=26%）。与对照组相比，乳糜泻患者中结直肠腺瘤的患病率没有增加（OR：0.94[0.65-1.38]），在评估高级别腺瘤的患病率时也未观察到显著差异（OR：0.97[0.48-1.97]）。
乳糜泻与结直肠腺瘤风险增加无关。然而，由于现有证据有限，需要更多研究来确定是否存在实际关联。
