Mizutani Mari, Kato Motohiko, Yamanoi Kazuhiro, Matsubara Akiko, Nakayama Atsushi, Fukuhara Kayoko, Iwata Kentaro, Miyazaki Kurato, Masunaga Teppei, Kubosawa Yoko, Hayashi Yukie, Takatori Yusaku, Akimoto Teppei, Matsuura Noriko, Bessho Rieko, Sujino Tomohisa, Takabayashi Kaoru, Ichikawa Hitoshi, Kashiwagi Kazuhiro, Takaishi Hiromasa, Sato Yasunori, Kanai Takanori, Kushima Ryoji, Yahagi Naohisa
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Tokyo, Japan.
Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Tokyo, Japan.
Endosc Int Open. 2024 Oct 28;12(10):E1206-E1213. doi: 10.1055/a-2341-9026. eCollection 2024 Oct.
The duodenum and colorectum are target organs for familial colorectal adenomatous polyposis, however, the association of duodenal epithelial tumors (DETs) and colorectal tumors is still controversial. The aim of our study was to elucidate the association between DET and colorectal tumor. This was an exploratory cross-sectional study of patients with DETs treated by endoscopic resection at our hospital, between November 2018 and October 2022. Individuals who underwent colonoscopy as part of the health screening comprised the reference control group for comparison. In both groups, lesions suspected of being tumors were resected. The main outcome was the adenoma detection rate (ADR). Other outcomes were the detection rate for advanced neoplasia (AN) and risk factors for colorectal adenoma and AN, evaluated using univariate and multivariable analyses. Analyses were based on data from 163 individuals in the DET group and 177 in the control group. ADR was higher in the DET (63.2%) than in the control (23.6%) group ( < 0.001). AN and invasive cancer rates were also significantly higher in the DET than in the control group (AN: 20.9% vs 3.4%, respectively, < 0.001; invasive cancer: 3.1% vs 0%, respectively, < 0.001). On logistic regression analysis, DET was found to be associated with a 5-fold increase in the detection rate of adenoma and 6-fold increase in AN detection. The study revealed significant association between DET and high ADR and a higher frequency of AN and invasive cancer. Screening colonoscopy is suggested for patients with DETs.
十二指肠和结肠直肠是家族性腺瘤性息肉病的靶器官，然而，十二指肠上皮肿瘤（DETs）与结直肠肿瘤之间的关联仍存在争议。我们研究的目的是阐明DETs与结直肠肿瘤之间的关联。这是一项对2018年11月至2022年10月期间在我院接受内镜切除治疗的DETs患者进行的探索性横断面研究。作为健康筛查一部分接受结肠镜检查的个体组成了用于比较的参考对照组。在两组中，对疑似肿瘤的病变进行了切除。主要结局是腺瘤检出率（ADR）。其他结局是高级别瘤变（AN）的检出率以及结直肠腺瘤和AN的危险因素，采用单变量和多变量分析进行评估。分析基于DET组的163名个体和对照组的177名个体的数据。DET组的ADR（63.2%）高于对照组（23.6%）（<0.001）。DET组的AN和浸润性癌发生率也显著高于对照组（AN：分别为20.9%和3.4%，<0.001；浸润性癌：分别为3.1%和0%，<0.001）。逻辑回归分析发现，DETs与腺瘤检出率增加5倍和AN检出率增加6倍相关。该研究揭示了DETs与高ADR以及更高频率的AN和浸润性癌之间存在显著关联。建议对DETs患者进行结肠镜筛查。
