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Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.结肠镜检查和息肉切除术后的随访建议:美国结直肠癌多学会特别工作组的共识更新
Am J Gastroenterol. 2020 Mar;115(3):415-434. doi: 10.14309/ajg.0000000000000544.
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NCCN Guidelines Insights: Genetic/Familial High-Risk Assessment: Colorectal, Version 2.2019.NCCN 指南解读:遗传/家族性高风险评估:结直肠癌,第 2.2019 版。
J Natl Compr Canc Netw. 2019 Sep 1;17(9):1032-1041. doi: 10.6004/jnccn.2019.0044.
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Update on Hereditary Colorectal Cancer: Improving the Clinical Utility of Multigene Panel Testing.遗传性结直肠癌更新:提高多基因面板检测的临床实用性。
Clin Colorectal Cancer. 2018 Jun;17(2):e293-e305. doi: 10.1016/j.clcc.2018.01.001. Epub 2018 Jan 11.
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Risk of advanced colorectal neoplasm in patients with more than 10 adenomas on index colonoscopy: A Korean Association for the Study of Intestinal Diseases (KASID) study.初次结肠镜检查发现10个以上腺瘤的患者发生晚期结直肠肿瘤的风险:韩国肠道疾病研究协会(KASID)的一项研究。
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Risk Factors for Recurrent High-Risk Polyps after the Removal of High-Risk Polyps at Initial Colonoscopy.初次结肠镜检查时切除高危息肉后复发性高危息肉的危险因素
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Global cancer statistics, 2012.全球癌症统计数据,2012 年。
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Hereditary colorectal cancer syndromes: American Society of Clinical Oncology Clinical Practice Guideline endorsement of the familial risk-colorectal cancer: European Society for Medical Oncology Clinical Practice Guidelines.遗传性结直肠癌综合征:美国临床肿瘤学会临床实践指南对家族性结直肠癌风险的认可:欧洲肿瘤内科学会临床实践指南。
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非遗传性大肠息肉病患者息肉复发及进展性腺瘤发生的临床特征与危险因素

Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis.

作者信息

Jang Jihun, Park Jihye, Park Soo Jung, Park Jae Jun, Cheon Jae Hee, Kim Tae Il

机构信息

Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.

Yonsei Cancer Prevention Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Intest Res. 2023 Oct;21(4):510-517. doi: 10.5217/ir.2022.00139. Epub 2023 May 31.

DOI:10.5217/ir.2022.00139
PMID:37248175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10626020/
Abstract

BACKGROUND/AIMS: Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis.

METHODS

This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development.

RESULTS

The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23-4.01), current smoking (HR, 2.39; 95% CI, 1.17-4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21-3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort.

CONCLUSIONS

The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.

摘要

背景/目的:累积息肉超过10个的患者可能存在更高的结直肠肿瘤发生的遗传风险。然而,很少有研究调查非遗传性结直肠息肉病患者息肉病复发及进展为晚期肿瘤的危险因素。

方法

本研究纳入了2012年1月至2021年9月在Severance医院诊断为累积息肉10个及以上的患者(n = 855)。排除已知与息肉病相关基因突变、已知遗传性息肉病综合征、信息不足、全结肠切除术以及随访时间少于3年的患者。最终,169例患者纳入分析。我们收集了临床数据,包括结肠镜监测结果,并对息肉病复发及进展为晚期肿瘤的危险因素进行Cox回归分析。

结果

169例患者以男性为主(84.02%),平均年龄64.19±9.92岁。首次结肠镜检查时腺瘤的平均数量为15.33±8.47个。多变量分析显示,除结肠癌外的癌症病史(风险比[HR],2.23;95%置信区间[CI],1.23 - 4.01)、当前吸烟(HR,2.39;95% CI,1.17 - 4.87)以及首次结肠镜检查时发现多个息肉(≥15个)(HR,2.05;95% CI,1.21 - 3.50)是息肉病复发的显著危险因素。在我们的队列中,未发现监测期间进展为晚期肿瘤的统计学显著危险因素。

结论

首次结肠镜检查时存在多个息肉(≥15个)、除结肠癌外的癌症病史以及当前吸烟状态是非遗传性结直肠息肉病患者息肉病复发的显著危险因素。