Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Vall d'Hebron Institute for Research (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
Mayo Clin Proc. 2021 Jan;96(1):132-146. doi: 10.1016/j.mayocp.2020.06.056.
To investigate the rate of colorectal neoplasms (CRNs) in patients who have Enterococcus faecalis infective endocarditis (EFIE) with available colonoscopies and to assess whether this is associated with the identification of a focus the infection.
Retrospective analysis of data from a prospective multicenter study involving 35 centers who are members of the Grupo de Apoyo para el Manejo de la Endocarditis en España [Support Group for the Management of Infective Endocarditis in Spain] cohort. A specific set of queries regarding information on colonoscopy and histopathology of colorectal diseases was sent to each participating center. Four-hundred sixty-seven patients with EFIE were included from January 1, 2008, to December 31, 2017, from whom data on colonoscopy performance and results were available in 411 patients.
One hundred forty-two (34.5%) patients had a colonoscopy close to the EFIE episode. The overall rate of colorectal diseases was 70.4% (100 of 142), whereas the prevalence of CRN (advanced adenomas and colorectal carcinoma) was 14.8% (21 of 142), with no significant differences between the group of EFIE of unknown focus and that with an identified focus.
Our study adds to prior evidence suggesting a much higher rate of CRN among patients with EFIE than in the general population of the same age and sex. In addition, our findings suggest that this phenomenon might take place both in EFIE with an unknown and an identified source of infection.
调查患有粪肠球菌感染性心内膜炎(EFIE)且接受结肠镜检查的患者中结直肠肿瘤(CRN)的发生率,并评估其与感染灶的确定是否相关。
回顾性分析了一项涉及西班牙感染性心内膜炎支持组(Grupo de Apoyo para el Manejo de la Endocarditis en España)35 个成员中心的前瞻性多中心研究的数据。向每个参与中心发送了一组关于结肠镜检查和结直肠疾病组织病理学信息的特定查询。从 2008 年 1 月 1 日至 2017 年 12 月 31 日,共纳入了 467 例 EFIE 患者,其中 411 例患者可获得结肠镜检查结果和数据。
142 例(34.5%)患者在 EFIE 发作前进行了结肠镜检查。结直肠疾病的总体发生率为 70.4%(142 例中的 100 例),而 CRN(高级腺瘤和结直肠癌)的患病率为 14.8%(142 例中的 21 例),EFIE 中未知感染灶组和已知感染灶组之间无显著差异。
我们的研究进一步证明,EFIE 患者的 CRN 发生率远高于同年龄和性别组的一般人群。此外,我们的发现表明,这种现象可能发生在 EFIE 中,无论感染源是否已知。