Nakamatsu Dai, Nishida Tsutomu, Kuriki Shinji, Chang Li-Sa, Aochi Kazuki, Meren Emi, Sakamoto Tatsuya, Tomita Ryo, Higaki Yu, Osugi Naoto, Sugimoto Aya, Takahashi Kei, Mukai Kaori, Matsumoto Kengo, Hayashi Shiro, Nakajima Sachiko, Yamamoto Masashi, Fukui Koji, Inada Masami
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan.
Endosc Int Open. 2021 Mar;9(3):E331-E337. doi: 10.1055/a-1333-1108. Epub 2021 Feb 18.
The relationship between acute colonic diverticulitis and colorectal cancer (CRC) is unclear, but colonoscopy is recommended to exclude malignancy. We compared the detection rates for colorectal neoplasia in patients with colonic diverticulitis and asymptomatic patients who had positive fecal immunochemical tests (FITs). In total, 282 patients with acute colonic diverticulitis were hospitalized in our hospital from February 2011 to December 2019. Of them, 143 patients with diverticulitis and 1819 with positive FITs patients during the same period underwent colonoscopy without a prior colonoscopy within 5 years. We retrospectively compared these patients in terms of the invasive CRC rate, advanced neoplasia detection rate (ANDR), adenoma detection rate (ADR), and polyp detection rate (PDR). Compared to the diverticulitis group, the FIT-positive group had a significantly higher CRC rate (0 vs 2.7 %, = 0.0061), ANDR (5.6 vs. 14.0 %, = 0.0017), ADR (19.6 vs. 53.2 %, < .0001), and PDR (44.1 vs. 91.0 %, < .0001). Using 1:1 propensity score matching based on age and sex, we obtained 276 matched patients in both groups. After matching, no difference was found in the CRC rate (0 vs 0.7 %) or ANDR (5.8 vs 7.3 %) between groups, but the ADR and PDR were significantly higher in the FIT-positive group (20.3 vs 43.5 %, < .0001; 45.7 % vs 86.2 %, < .0001). Patients with acute diverticulitis had lower ADRs and PDRs than patients with positive FITs.
急性结肠憩室炎与结直肠癌（CRC）之间的关系尚不清楚，但建议进行结肠镜检查以排除恶性肿瘤。我们比较了结肠憩室炎患者和粪便免疫化学试验（FIT）呈阳性的无症状患者中结直肠肿瘤的检出率。2011年2月至2019年12月期间，共有282例急性结肠憩室炎患者在我院住院。其中，143例憩室炎患者和同期1819例FIT呈阳性的患者在5年内未进行过结肠镜检查，此次接受了结肠镜检查。我们对这些患者的浸润性CRC发生率、高级别肿瘤检出率（ANDR）、腺瘤检出率（ADR）和息肉检出率（PDR）进行了回顾性比较。与憩室炎组相比，FIT阳性组的CRC发生率（0%对2.7%，P = 0.0061）、ANDR（5.6%对14.0%，P = 0.0017）、ADR（19.6%对53.2%，P < 0.0001）和PDR（44.1%对91.0%，P < 0.0001）显著更高。基于年龄和性别进行1:1倾向评分匹配后，两组各有276例匹配患者。匹配后，两组间的CRC发生率（0%对0.7%）或ANDR（5.8%对7.3%）无差异，但FIT阳性组的ADR和PDR显著更高（20.3%对43.5%，P < 0.0001；45.7%对86.2%，P < 0.0001）。急性憩室炎患者的ADR和PDR低于FIT阳性患者。
