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肢端肥大症患者结肠息肉及其他结肠病变的患病率和危险因素:结肠镜筛查的见解

Prevalence and risk factors of colon polyps and other colonic lesions in acromegaly: Insights from colonoscopy screening.

作者信息

Hepşen Sema, Üçgül Enes, Menekşe Burak, Helvacı Burçak Cavnar, Ünver Ceren Karaçalık, Durantaş Halil, Boz Oğulcan, Coşkun Yusuf, Çakal Başak, Kızılgül Muhammed, Çakal Erman

机构信息

Department of Endocrinology and Metabolism, Ankara Etlik City Hospital, Ankara, Türkiye.

Department of Gastroenterology, Ankara Etlik City Hospital, Ankara, Türkiye.

出版信息

Pituitary. 2025 Apr 1;28(2):44. doi: 10.1007/s11102-025-01513-4.

Abstract

PURPOSE

The existing data on colon lesions in acromegaly is notably heterogeneous. This study aimed to analyze the endoscopic and histopathological characteristics of colon polyps and other colonic lesions in acromegaly patients.

METHODS

This case-control study included 192 acromegaly patients and 256 controls. Colon polyps were categorized based on their size and histopathological classification. Colon malignancies and other colonic lesions, such as anal fissures, hemorrhoids, and diverticulosis, were also documented.

RESULTS

The prevalence of colon polyps was higher in the acromegaly group than in controls (p = 0.003), however, no differences were observed in the number, size, or histopathological subtypes of the polyps. Polyps in acromegaly patients were predominantly located in the distal colon and rectum. Multiple polyp locations and histopathological subtypes were more frequent in the control group (p = 0.042 and p = 0.018). Rates of low-grade dysplasia, high-grade dysplasia, and malignancy were similar between groups. Anal fissures were more common in the acromegaly group, whereas diverticulosis was less frequent (p = 0.001 and p < 0.001; respectively). Logistic regression analysis identified no significant clinical or laboratory predictors for colon polyps in acromegaly.

CONCLUSION

Patients with acromegaly exhibited a higher prevalence of colon polyps, predominantly located in the distal colon, which typically displayed a single histopathological subtype. No increased rates of colonic dysplasia, colon cancer, or other colonic lesions were observed in patients with acromegaly, except for an elevated prevalence of anal fissures.

摘要

目的

关于肢端肥大症患者结肠病变的现有数据明显异质性。本研究旨在分析肢端肥大症患者结肠息肉及其他结肠病变的内镜和组织病理学特征。

方法

本病例对照研究纳入了192例肢端肥大症患者和256例对照。结肠息肉根据其大小和组织病理学分类进行归类。还记录了结肠恶性肿瘤及其他结肠病变,如肛裂、痔疮和憩室病。

结果

肢端肥大症组结肠息肉的患病率高于对照组(p = 0.003),然而,息肉的数量、大小或组织病理学亚型未观察到差异。肢端肥大症患者的息肉主要位于结肠远端和直肠。对照组中息肉多部位分布和组织病理学亚型更常见(p = 0.042和p = 0.018)。两组间低级别异型增生、高级别异型增生和恶性肿瘤的发生率相似。肛裂在肢端肥大症组更常见,而憩室病较少见(分别为p = 0.001和p < 0.001)。逻辑回归分析未发现肢端肥大症患者结肠息肉的显著临床或实验室预测因素。

结论

肢端肥大症患者结肠息肉患病率较高,主要位于结肠远端,通常表现为单一组织病理学亚型。除肛裂患病率升高外,未观察到肢端肥大症患者结肠异型增生、结肠癌或其他结肠病变的发生率增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5172/11961538/6294a2f91475/11102_2025_1513_Fig1_HTML.jpg

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