Ramphal Winesh, Schreinemakers Jennifer M J, Seerden Tom C J, Gobardhan Paul D
Department of Surgery Amphia Hospital Breda, Breda, the Netherlands.
Department of Gastroenterology Amphia Hospital Breda, Breda, the Netherlands.
Dig Dis. 2018;36(5):362-368. doi: 10.1159/000489926. Epub 2018 Jun 26.
The association between diverticulitis and colorectal cancer (CRC) remains unclear, though both share epidemiological characteristics. The aim of this study was to investigate whether there is higher risk for CRC after an episode of uncomplicated diverticulitis. Furthermore, in cases of CRC, we sought to determine specific tumour characteristics.
This retrospective observational study includes patients with acute diverticulitis (Hinchey 0 and 1) who were conservatively treated with or without antibiotics between 2008 and 2013. Patients with endoscopic follow-up were included for analysis. Tumour characteristics of patients diagnosed with CRC during colonoscopic follow-up according to patients' presentation of alarm symptoms were considered to be the primary endpoint.
A total of 977 patients were conservatively treated for an episode of acute diverticulitis, 645 of whom underwent colonoscopy during follow-up. Ten patients were diagnosed with CRC, nine of whom exhibited alarm symptoms. One patient was diagnosed with stage I disease, 4 had stage II, and 5 had stage III disease.
This study strongly suggests that even though CRC is rare after uncomplicated diverticulitis, in cases of alarm symptoms, a colonoscopy is indicated. In cases where CRC is diagnosed, it is often advanced with a higher TNM stage and poor prognosis.
憩室炎与结直肠癌（CRC）之间的关联尚不清楚，尽管二者具有共同的流行病学特征。本研究的目的是调查单纯性憩室炎发作后患结直肠癌的风险是否更高。此外，对于结直肠癌病例，我们试图确定其特定的肿瘤特征。
这项回顾性观察研究纳入了2008年至2013年间接受保守治疗（使用或未使用抗生素）的急性憩室炎（Hinchey 0和1级）患者。纳入接受内镜随访的患者进行分析。根据患者的警示症状表现，将结肠镜随访期间诊断为结直肠癌患者的肿瘤特征视为主要终点。
共有977例患者因急性憩室炎发作接受了保守治疗，其中645例在随访期间接受了结肠镜检查。10例患者被诊断为结直肠癌，其中9例表现出警示症状。1例患者被诊断为I期疾病，4例为II期，5例为III期疾病。
本研究强烈表明，尽管单纯性憩室炎后结直肠癌很少见，但出现警示症状时，建议进行结肠镜检查。在诊断为结直肠癌的病例中，肿瘤通常处于进展期，TNM分期较高且预后较差。
