Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul, Korea.
Department of Gastroenterology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul, Korea.
Sci Rep. 2021 Jul 19;11(1):14730. doi: 10.1038/s41598-021-94030-w.
Although 18-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is useful for detecting synchronous colorectal cancer (CRC) in stenotic CRC, long-term outcomes of patients without synchronous FDG-avid lesions are not well reported. We investigated postoperative colonoscopy results in patients with left-sided stenosing CRC without synchronous FDG-avid lesions. In this retrospective review, 754 patients with left-sided CRC without synchronous FDG-avid lesions on preoperative 18F-FDG PET/CT were divided into two groups based on the completeness of preoperative colonoscopy. Propensity score matching was performed to balance baseline characteristics. Results of postoperative colonoscopy were compared in both the unmatched and matched cohorts. At 1 and 5 years after surgery, the cumulative risk of advanced adenoma (AA) or carcinoma (CA) in all patients, risk of CA, and additional surgical risk were 1.8% and 10.1%, 0.1% and 0.4%, and 0% and 0.5%, respectively. In both cohorts, the AA risk was significantly higher in the incomplete colonoscopy group. However, the risk of CA showed no between-group difference in the matched cohort. Additional surgical risk did not differ between the two groups. Thus, the finding of negative FDG-avid lesions in the proximal colon in addition to the target CRC ensures the absence of additional lesions warranting surgical plan changes.
虽然 18-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）有助于检测狭窄性结直肠癌（CRC）中的同步结直肠癌，但尚无关于无同步 FDG 摄取病变患者的长期结果的报道。我们研究了无同步 FDG 摄取病变的左侧狭窄性 CRC 患者的术后结肠镜检查结果。在这项回顾性研究中，根据术前 18F-FDG PET/CT 上是否存在同步 FDG 摄取病变，将 754 例无同步 FDG 摄取病变的左侧 CRC 患者分为两组。采用倾向评分匹配来平衡基线特征。比较了未匹配和匹配队列的术后结肠镜检查结果。在手术后 1 年和 5 年，所有患者的高级腺瘤（AA）或癌（CA）累积风险、CA 风险和额外手术风险分别为 1.8%和 10.1%、0.1%和 0.4%和 0%和 0.5%。在两个队列中，不完全结肠镜检查组的 AA 风险均显著更高。然而，匹配队列中 CA 风险无组间差异。两组的额外手术风险无差异。因此，在目标 CRC 之外，近端结肠发现阴性 FDG 摄取病变可确保不存在需要手术计划改变的其他病变。
