Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury, 10-719 Olsztyn, Poland.
Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, 11-041 Olsztyn, Poland.
Medicina (Kaunas). 2022 Nov 30;58(12):1767. doi: 10.3390/medicina58121767.
Background and Objectives: Aberrant crypt foci (ACF) are one of the earliest putative preneoplastic and, in some cases, neoplastic lesions in human colons. Many studies have confirmed the reduction of ACFs and colorectal adenomas after treatment with acetylsalicylic acid (ASA) commonly referred to as ASA; however, the minimum effective dose of ASA and the duration of use has not been fully elucidated. The objective of our study was to assess the significance of low dose ASA (75-mg internally once daily) to study the chemopreventive effect of ASA in ACF and adenomas development in patients taking this drug for a minimum period of 10 years. Materials and Methods: Colonoscopy, combined with rectal mucosa staining with 0.25% methylene blue, was performed on 131 patients. The number of rectal ACF in the colon was divided into three groups: ACF < 5; ACF 5−10; and ACF > 10. Patients were divided into two groups: the “With ASA” group (the study group subjects taking ASA 75-mg daily for 10 years); and “Without ASA” group (control group subjects not taking ASA chronically). The incidence of different types of rectal ACF and colorectal polyps in both groups of subjects was analysed and ascertained. Results: Normal ACF was found in 12.3% in the study group vs. 87.7% control group, hyperplastic 22.4% vs. 77.6%, dysplastic 25% vs. 75%, mixed 0% vs. 100%. Treatment with ASA affects the occurrence of colorectal adenomas. The amount of dysplastic ACFs was lower in the study group than in the control group. The increase in dysplastic ACFs decreases with age in both groups, with the increase greater in those not taking ASA. Conclusions: Patients who take persistent, chronic (>10 years) low doses of ASA have a lower total number of all types of rectal ACFs and adenomas compared to the control group.
异常隐窝病灶（ACF）是人类结肠中最早的一种潜在癌前病变，在某些情况下也是肿瘤病变。许多研究证实，使用乙酰水杨酸（ASA）治疗后，ACF 和结直肠腺瘤的数量会减少，通常称为 ASA；然而，ASA 的最低有效剂量和使用时间尚未完全阐明。本研究的目的是评估低剂量 ASA（每天 75 毫克口服）的意义，以研究该药物在 ACF 和腺瘤发展中的化学预防作用，这些患者至少服用该药物 10 年。
对 131 例患者进行结肠镜检查，并结合直肠黏膜 0.25%亚甲蓝染色。将结肠直肠 ACF 的数量分为三组：ACF<5；ACF 5-10；和 ACF>10。将患者分为两组：“服用 ASA”组（研究组，每天服用 ASA 75 毫克，持续 10 年）；和“未服用 ASA”组（对照组，不长期服用 ASA）。分析并确定两组患者不同类型直肠 ACF 和结直肠息肉的发生率。
研究组正常 ACF 占 12.3%，对照组占 87.7%；增生性 ACF 占 22.4%，对照组占 77.6%；发育不良 ACF 占 25%，对照组占 75%；混合性 ACF 占 0%，对照组占 100%。ASA 的治疗影响结直肠腺瘤的发生。研究组发育不良 ACF 的数量低于对照组。两组中发育不良 ACF 的数量随年龄的增加而增加，未服用 ASA 的患者增加更多。
与对照组相比，持续、长期（>10 年）服用低剂量 ASA 的患者，所有类型的直肠 ACF 和腺瘤总数较低。
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