Department of, 1Gastroenterology and Hepatology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Gastroenterology and Hepatology, Erasmus Medical Center University Hospital, Rotterdam, The Netherlands.
Dig Endosc. 2022 Jan;34(1):163-170. doi: 10.1111/den.14004. Epub 2021 Jun 8.
Hodgkin's lymphoma (HL) survivors treated with abdominal radiotherapy and/or procarbazine have an increased risk of developing colorectal neoplasia.
We evaluated the clinicopathological characteristics and risk factors for developing (advanced) neoplasia (AN) in HL survivors.
In all, 101 HL survivors (median age 51 years, median age of HL diagnosis 25 years) underwent colonoscopy and 350 neoplasia and 44 AN (classified as advanced adenomas/serrated lesions or colorectal cancer), mostly right-sided, were detected, as published previously. An average-risk asymptomatic cohort who underwent screening colonoscopy were controls (median age 60 years). Clinicopathological characteristics of AN were evaluated in both groups. Mismatch repair (MMR) status was assessed using immunohistochemistry (MLH1/MSH2/MSH6/PMS2). Logistic regression analysis was performed to evaluate the risk factors for AN in HL survivors, including age at HL diagnosis and interval between HL and colonoscopy.
In 101 colonoscopies in HL survivors, AN was primarily classified based on polyp size ≥10 mm, whereas (high-grade)dysplasia was more often seen in AN in controls. An interval between HL diagnosis and colonoscopy >26 years was associated with more AN compared with an interval of <26 years, with an odds ratio for AN of 3.8 (95% confidence interval 1.4-9.1) (p < 0.01). All 39 AN that were assessed were MMR proficient.
Colorectal neoplasia in HL survivors differ from average-risk controls; classification AN was primarily based on polyp size (≥10 mm) in HL survivors. Longer follow-up between HL diagnosis and colonoscopy was associated with a higher prevalence of AN in HL survivors.
接受腹部放疗和/或丙卡巴肼治疗的霍奇金淋巴瘤 (HL) 幸存者发生结直肠肿瘤的风险增加。
我们评估了 HL 幸存者发生（高级）肿瘤（AN）的临床病理特征和危险因素。
共有 101 名 HL 幸存者（中位年龄 51 岁，HL 诊断中位年龄 25 岁）接受了结肠镜检查，此前已发表报道其中 350 例发现了肿瘤，44 例发现了 AN（分为高级腺瘤/锯齿状病变或结直肠癌），大多数为右侧。接受筛查性结肠镜检查的平均风险无症状队列为对照组（中位年龄 60 岁）。评估了两组 AN 的临床病理特征。使用免疫组织化学法（MLH1/MSH2/MSH6/PMS2）评估错配修复（MMR）状态。使用逻辑回归分析评估 HL 幸存者发生 AN 的危险因素，包括 HL 诊断时的年龄和 HL 与结肠镜检查之间的间隔。
在 101 例 HL 幸存者的结肠镜检查中，AN 主要根据息肉大小≥10mm进行分类，而对照组的 AN 则更常出现（高级别）异型增生。与间隔<26 年相比，HL 诊断与结肠镜检查之间的间隔>26 年与 AN 的发生相关，AN 的比值比为 3.8（95%置信区间 1.4-9.1）（p<0.01）。所有 39 例接受评估的 AN 均为 MMR 功能正常。
HL 幸存者的结直肠肿瘤与一般风险对照组不同；AN 的分类主要基于 HL 幸存者的息肉大小（≥10mm）。HL 诊断与结肠镜检查之间的随访时间较长与 HL 幸存者中 AN 的发生率较高相关。
