Jung Yoon Suk, Park Jung Ho, Park Chan Hyuk
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea.
Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Korea.
J Pers Med. 2021 Feb 12;11(2):120. doi: 10.3390/jpm11020120.
No specific recommendations are available for the surveillance of young patients aged <50 years undergoing polypectomy. We aimed to compare the risk of metachronous advanced colorectal neoplasia (ACRN) between patients aged ≥50 years and those aged <50 years who underwent polypectomy. Studies published between January 1980 and June 2020 that examined the risk of metachronous ACRN were searched. We performed a meta-analysis for the metachronous ACRN risk in patients with sporadic colorectal adenomas according to the age groups (≥50 vs. <50 years). Eight individual studies were included in the meta-analysis. The risk of metachronous ACRN was higher in patients aged ≥50 years than in those aged <50 years without significant heterogeneity (odds ratio (OR) (95% CI): 1.62 (1.34-1.96), = 14%). The impact of the age group on the risk of metachronous ACRN was identified in both the low-risk (LRA) and high-risk (HRA) adenoma groups (≥50 vs. <50 years: LRA, OR 1.88 (95% CI 1.30-2.70); HRA, OR 1.50 [95% CI 1.13-2.00]). In conclusion, patients aged <50 years had a lower risk of metachronous ACRN than older patients. Young patients with sporadic adenomas do not require more intensive surveillance; rather, the surveillance interval may be extended in these patients.
对于年龄小于50岁接受息肉切除术的年轻患者，目前尚无具体的监测建议。我们旨在比较年龄≥50岁和年龄<50岁接受息肉切除术的患者发生异时性晚期结直肠肿瘤（ACRN）的风险。检索了1980年1月至2020年6月间发表的研究异时性ACRN风险的文献。我们根据年龄组（≥50岁与<50岁）对散发性结直肠腺瘤患者发生异时性ACRN的风险进行了荟萃分析。八项个体研究纳入了荟萃分析。年龄≥50岁的患者发生异时性ACRN的风险高于年龄<50岁的患者，且无显著异质性（优势比（OR）（95%CI）：1.62（1.34 - 1.96），I² = 14%）。在低风险（LRA）和高风险（HRA）腺瘤组中均发现年龄组对异时性ACRN风险有影响（≥50岁与<50岁：LRA，OR 1.88（95%CI 1.30 - 2.70）；HRA，OR 1.50 [95%CI 1.13 - 2.00]）。总之，年龄<50岁的患者发生异时性ACRN的风险低于老年患者。散发性腺瘤的年轻患者不需要更密集的监测；相反，这些患者的监测间隔可以延长。
