Völkerer Andreas, Wernly Sarah, Semmler Georg, Flamm Maria, Ausserwinkler Mathias, Datz Leonora, Götz Nikolaus, Hofer Hannah, Aigner Elmar, Datz Christian, Wernly Bernhard
Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria.
Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2024 Oct 12;13(20):6078. doi: 10.3390/jcm13206078.
Colorectal neoplasia and diverticulosis are common findings on colonoscopies. While adenomas are precursors to colorectal cancer, diverticulosis is usually asymptomatic but can lead to diverticulitis. Despite their prevalence and coexistence, the relationship between these conditions remains unclear. This study investigates whether diverticulosis is associated with adenomas, considering shared risk factors and potential inflammation-driven mechanisms. We examined 6154 asymptomatic individuals undergoing colorectal cancer screening in Austria. Diverticulosis and colorectal neoplasia were documented during screenings based on macroscopic definitions. Advanced neoplasia was defined as polyps >1 cm or high-grade dysplasia. Associations between diverticulosis and neoplastic findings were assessed using univariate and multivariable logistic regression models. Although the overall incidence of any polypoid lesion was higher in the diverticulosis group (37% vs. 30%), statistical analysis revealed a comparable rate of advanced neoplasms in both groups. Importantly, no significant link between diverticulosis and advanced neoplasms was found (OR 1.125; 95% CI: 0.933 to 1.357, = 0.218) even after adjusting for confounding factors. In a univariate analysis, a statistically significant association between diverticulosis and the presence of any colorectal polyps was identified (OR 1.388; 95% CI: 1.244-1.549, < 0.0001). However, after adjusting for confounding factors in model 2 (OR 1.065, 95% CI: 0.942 to 1.204, = 0.314) and model 3 (OR 1.071, 95% CI: 0.925 to 1.239, = 0.360), this effect was also not statistically significant. Patients with diverticulosis share demographic and clinical features with those at risk of colorectal neoplasia, such as older age, male gender, and higher cardiometabolic risk. However, diverticulosis does not independently increase the risk of advanced colorectal neoplasia or unspecified polypoid lesions.
结直肠肿瘤和憩室病是结肠镜检查中常见的发现。虽然腺瘤是结直肠癌的癌前病变，但憩室病通常无症状，但可导致憩室炎。尽管它们很常见且并存，但这些病症之间的关系仍不清楚。本研究探讨憩室病是否与腺瘤有关，同时考虑共同的风险因素和潜在的炎症驱动机制。我们检查了在奥地利接受结直肠癌筛查的6154名无症状个体。根据宏观定义在筛查期间记录憩室病和结直肠肿瘤。高级别肿瘤被定义为息肉>1厘米或高级别发育异常。使用单变量和多变量逻辑回归模型评估憩室病与肿瘤发现之间的关联。虽然憩室病组中任何息肉样病变的总体发生率较高（37%对30%），但统计分析显示两组中高级别肿瘤的发生率相当。重要的是，即使在调整混杂因素后，也未发现憩室病与高级别肿瘤之间存在显著关联（OR 1.125；95%CI：0.933至1.357，P = 0.218）。在单变量分析中，发现憩室病与任何结直肠息肉的存在之间存在统计学上的显著关联（OR 1.388；95%CI：1.244 - 1.549，P < 0.0001）。然而，在模型2（OR 1.065，95%CI：0.942至1.204，P = 0.314）和模型3（OR 1.071，95%CI：0.925至1.239，P = 0.360）中调整混杂因素后，这种效应也无统计学意义。憩室病患者与有结直肠肿瘤风险的患者具有共同的人口统计学和临床特征，如年龄较大、男性以及较高的心脏代谢风险。然而，憩室病并不会独立增加高级别结直肠肿瘤或未指定的息肉样病变的风险。
