Universidade Federal de Minas Gerais, Hospital das Clínicas, Instituto Alfa de Gastroenterologia, Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais, Hospital das Clínicas, Divisão de Transplante de Fígado, Belo Horizonte, MG, Brasil.
Arq Gastroenterol. 2022 Jan-Mar;59(1):35-39. doi: 10.1590/S0004-2803.202200001-07.
Mandatory colonoscopy in liver transplantation (LT) candidates is recommended but still controversial.
To investigate the frequency of colonoscopy lesions in order to support colorectal cancer (CRC) screening in a real-world pre-LT cohort.
Retrospective study conducted at a single-center included 632 subjects who underwent pre-transplantation colonoscopy.
Median age was 56.9 years (yr.) old (82.3% were ≥50 yr.). Primary sclerosing cholangitis (PSC) occurred in 4.6%. Colonoscopy was abnormal in 438 (69.3%) by detection of polyps (37.7%), vascular changes (29.9%), diverticulosis (18.4%), inflammatory bowel disease features (5.2%) and CRC (0.6%). Histology was available in 66.8% of polyps: hyperplastic (47.8%), low-grade dysplasia (56.6%) and high-grade dysplasia (3.8%). High-risk adenomas occurred in 8.2% of the 594 subjects evaluated. Individuals ≥50 yr. were more likely to present abnormal colonoscopy and polyps. High-grade dysplasia and CRC were only found in individuals ≥50 yr. Patients with high-risk adenomas were more likely to be ≥50 yr.: there was no association between high-risk adenomas detection and liver disease etiology or PSC diagnosis.
Most LT candidates presented abnormal colonoscopy examination, especially by polyps presence. All cases of high-grade dysplasia and CRC occurred in patients ≥50 yr., regardless of disease etiology.
在肝移植（LT）受者中进行强制性结肠镜检查是被推荐的，但仍存在争议。
调查结肠镜检查病变的频率，以支持在真实世界的 LT 前队列中进行结直肠癌（CRC）筛查。
对单中心进行的回顾性研究纳入了 632 例接受移植前结肠镜检查的患者。
中位年龄为 56.9 岁（82.3%为≥50 岁）。原发性硬化性胆管炎（PSC）占 4.6%。通过检测息肉（37.7%）、血管变化（29.9%）、憩室病（18.4%）、炎症性肠病特征（5.2%）和 CRC（0.6%）发现，438 例（69.3%）结肠镜检查异常。息肉的组织学结果在 66.8%的病例中可用：增生性（47.8%）、低级别异型增生（56.6%）和高级别异型增生（3.8%）。在 594 例接受评估的患者中，发生高危腺瘤的比例为 8.2%。≥50 岁的患者更有可能出现异常结肠镜检查和息肉。高级别异型增生和 CRC 仅在≥50 岁的患者中发现。存在高危腺瘤的患者更有可能≥50 岁：高危腺瘤的检出与肝脏疾病病因或 PSC 诊断之间无关联。
大多数 LT 候选者的结肠镜检查异常，尤其是存在息肉。所有高级别异型增生和 CRC 病例均发生在≥50 岁的患者中，与疾病病因无关。
