Gastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Gastroenterology Unit, Giuseppe Mazzini Hospital, 64100 Teramo, Italy.
Medicina (Kaunas). 2021 Jan 25;57(2):108. doi: 10.3390/medicina57020108.
Conflicting evidence is reported regarding any association between colonic diverticula with colorectal adenomas or cancer. The present study aimed to evaluate, in a cohort of Caucasian patients, the association between colonic diverticula and colorectal polyps and cancer. All consecutive patients undergoing colonoscopy at our institution were included in the study. The presence and location of diverticula, polyps, and cancers were recorded. Histologically, polyps were classified as adenoma (with low or high dysplasia), hyperplastic, or inflammatory. The relative risk of the association of polyps and cancer with diverticula was assessed. Multiple logistic regression analyses, including age, sex, family history for colorectal cancer (CRC), and family history for diverticula, were carried out. During the study period, 1490 patients were enrolled; 37.2% ( = 555) showed colonic diverticula or polyps or CRC (308 males, mean age 66 years). Particularly, 12.3% ( = 183) patients presented only diverticula, 13.7% ( = 204) only polyps or cancer, 11.3% ( = 168) both diseases, and 62.7% ( = 935) neither diverticula nor polyps and cancer. A total of 38 patients presented colorectal cancer, 17 of which had also diverticula. A significant increase in relative risk (RR 2.81, 95% CI 2.27-3.47, < 0.0001) of colorectal adenoma and cancer in patients with colonic diverticula was found. At multivariate analysis, only diverticula resulted to be significantly associated with colorectal adenomas and cancer (Odds Ratio, OR 3.86, 95% CI 2.90-5.14, < 0.0001). A significant association of colonic diverticula with colorectal adenoma or cancer was found. This implies that patients with colonic diverticula require a vigilant follow-up procedure for the prevention of colorectal cancer from those applicable to the general population.
关于结肠憩室与结直肠腺瘤或癌症之间的任何关联，均有相互矛盾的证据。本研究旨在评估在一组白种人群中，结肠憩室与结直肠息肉和癌症之间的关联。本研究纳入了在我院行结肠镜检查的所有连续患者。记录憩室、息肉和癌症的存在和位置。组织学上，息肉分为腺瘤（低或高级别异型增生）、增生性或炎性。评估了息肉和癌症与憩室相关的相对风险。进行了多变量逻辑回归分析，包括年龄、性别、结直肠癌（CRC）家族史和憩室家族史。在研究期间，共纳入 1490 例患者；37.2%（=555）患者存在结肠憩室或息肉或 CRC（308 例男性，平均年龄 66 岁）。特别是，12.3%（=183）患者仅存在憩室，13.7%（=204）患者仅存在息肉或癌症，11.3%（=168）患者同时存在两种疾病，62.7%（=935）患者既无憩室也无息肉和癌症。共有 38 例患者患有结直肠癌，其中 17 例患者同时存在憩室。结果发现，存在结肠憩室的患者结直肠腺瘤和癌症的相对风险（RR 2.81，95%CI 2.27-3.47，<0.0001）显著增加。多变量分析显示，仅憩室与结直肠腺瘤和癌症显著相关（比值比，OR 3.86，95%CI 2.90-5.14，<0.0001）。发现结肠憩室与结直肠腺瘤或癌症存在显著关联。这意味着结肠憩室患者需要进行更严格的随访，以预防结直肠癌，这种随访策略适用于一般人群。
