Jang Jihun, Park Jihye, Park Soo Jung, Park Jae Jun, Cheon Jae Hee, Kim Tae Il
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.
Intest Res. 2023 Oct;21(4):510-517. doi: 10.5217/ir.2022.00139. Epub 2023 May 31.
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.
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.
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.
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.
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。
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。
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。
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。