Chautard Romain, Malka David, Samaha Elia, Tougeron David, Barbereau Didier, Caron Olivier, Rahmi Gabriel, Barrioz Thierry, Cellier Christophe, Feau Sandrine, Lecomte Thierry
Department of Hepatogastroenterology and Digestive Oncology, Trousseau University Hospital, CHU de Tours, CEDEX 09, 37044 Tours, France.
Gastrointestinal Oncology Unit, Department of Oncologic Medicine, Institut Gustave Roussy, Université Paris Sud, 94805 Villejuif, France.
Cancers (Basel). 2021 Apr 1;13(7):1657. doi: 10.3390/cancers13071657.
Patients with Lynch syndrome are at increased risk of gastric and duodenal cancer. Upper gastrointestinal endoscopy surveillance is generally proposed, even though little data are available on upper gastrointestinal endoscopy in these patients. The aim of this retrospective study was to evaluate the prevalence and incidence of gastrointestinal lesions following upper gastrointestinal endoscopy examination in Lynch patients.
A large, multicentre cohort of 172 patients with a proven germline mutation in one of the mismatch repair genes and at least one documented upper gastrointestinal endoscopy screening was assessed. Detailed information was collected on upper gastrointestinal endoscopy findings and the outcome of endoscopic follow-up.
Seventy neoplastic gastrointestinal lesions were diagnosed in 45 patients (26%) out of the 172 patients included. The median age at diagnosis of upper gastrointestinal lesions was 54 years. The prevalence of cancer at initial upper gastrointestinal endoscopy was 5% and the prevalence of precancerous lesions was 12%. Upper gastrointestinal lesions were more frequent after 40 years of age ( < 0.001). infection was associated with an increased prevalence of gastric, but not duodenal, lesions ( < 0.001).
Neoplastic upper gastrointestinal lesions are frequent in patients with Lynch syndrome, especially in those over 40 years of age. The results of our study suggest that Lynch patients should be considered for upper gastrointestinal endoscopic and screening.
林奇综合征患者患胃癌和十二指肠癌的风险增加。尽管关于这些患者上消化道内镜检查的数据很少，但通常仍建议进行上消化道内镜监测。这项回顾性研究的目的是评估林奇综合征患者上消化道内镜检查后胃肠道病变的患病率和发病率。
评估了一个大型多中心队列，其中172例患者在错配修复基因之一中存在已证实的种系突变，并且至少有一次记录在案的上消化道内镜筛查。收集了有关上消化道内镜检查结果和内镜随访结果的详细信息。
在纳入的172例患者中，有45例（26%）诊断出70处胃肠道肿瘤性病变。上消化道病变诊断时的中位年龄为54岁。初次上消化道内镜检查时癌症的患病率为5%，癌前病变的患病率为12%。40岁以后上消化道病变更为常见（<0.001）。感染与胃部病变（而非十二指肠病变）患病率增加相关（<0.001）。
林奇综合征患者上消化道肿瘤性病变很常见，尤其是40岁以上的患者。我们的研究结果表明，应考虑对林奇综合征患者进行上消化道内镜检查和[此处英文不完整，无法准确翻译]筛查。
