Fedeli Paolo, Masotti Monica, Marzano Chiara, Dezi Angelo, Scaccianone Giuseppe, Martinelli Elisabetta, Montenegro Lucia, Giovannone Maurizio, Zannella Alessandra, Gigliozzi Alessandro, Azzarone Alessandro, Bringiotti Roberto, Zampaletta Costantino, Sacchi Maria Carlotta, Ridola Lorenzo, Spagnoli Alessandra, Berardi Sabrina, Zullo Angelo
Gastroenterology Unit, Santo Spirito in Sassia Hospital, Rome (Paolo Fedeli, Monica Masotti).
Gastroenterology Unit, San Filippo Neri Hospital, Rome (Chiara Marzano, Angelo Dezi).
Ann Gastroenterol. 2025 Jan-Feb;38(1):68-71. doi: 10.20524/aog.2024.0928. Epub 2024 Dec 12.
Data on the potential association between diverticulosis and colonic neoplastic lesions are still controversial. We investigated this issue in subjects who underwent screening colonoscopy.
We reviewed the data of subjects with a positive fecal immunological test who underwent a first colonoscopy in the national colorectal screening program. Endoscopic and histological reports were evaluated, using both univariate and multivariate analyses to search for an association between diverticulosis and colonic neoplastic lesions.
Data from 5050 subjects (males: 52.2%; mean age: 61.7±6.5 years) observed in the 7 participating centers were considered. Diverticula were found in 2176 (43.1%) cases; at least 1 adenoma was detected in 2277 (45.1%) patients, at least 1 advanced adenoma in 842 (16.7%); and cancer was diagnosed in 159 (3.1%) cases. By univariate analysis, the prevalence of adenomas in patients with diverticula (46.7%, 95% confidence interval [CI] 44.6-48.8%) was significantly higher than in controls (43.8%, 95%CI 42.1-45.7%; P=0.041), while prevalences of both advanced adenomas (13.8%, 95%CI 16.3-19.5%) and cancers (2.4%, 95%CI 1.7-3.1% vs. 3.7%, 95%CI 3.1-4.4%) were lower. By multivariate analysis, only male sex (odds ratio [OR] range: 1.54-2.05) and age (OR range: 1.03-1.05) were found to be independent variables associated with different neoplastic lesions in the colon, whilst diverticulosis was not.
This large, multicenter study found no significant association between diverticulosis and neoplastic lesions in subjects who underwent screening colonoscopy.
憩室病与结肠肿瘤性病变之间潜在关联的数据仍存在争议。我们在接受筛查结肠镜检查的受试者中对这一问题进行了调查。
我们回顾了在国家结直肠癌筛查项目中首次接受结肠镜检查且粪便免疫检测呈阳性的受试者的数据。对内窥镜和组织学报告进行评估，采用单变量和多变量分析来寻找憩室病与结肠肿瘤性病变之间的关联。
考虑了在7个参与中心观察到的5050名受试者的数据（男性：52.2%；平均年龄：61.7±6.5岁）。2176例（43.1%）发现有憩室；2277例（45.1%）患者检测到至少1个腺瘤，842例（16.7%）检测到至少1个高级别腺瘤；159例（3.1%）诊断为癌症。单变量分析显示，有憩室的患者中腺瘤的患病率（46.7%，95%置信区间[CI]44.6 - 48.8%）显著高于对照组（43.8%，95%CI 42.1 - 45.7%；P = 0.041），而高级别腺瘤（13.8%，95%CI 16.3 - 19.5%）和癌症（2.4%，95%CI 1.7 - 3.1%对3.7%，95%CI 3.1 - 4.4%）的患病率较低。多变量分析显示，只有男性（比值比[OR]范围：1.54 - 2.05）和年龄（OR范围：1.03 - 1.05）是与结肠不同肿瘤性病变相关的独立变量，而憩室病不是。
这项大型多中心研究发现，在接受筛查结肠镜检查的受试者中，憩室病与肿瘤性病变之间无显著关联。
