Bond J H
Gastroenterology Section (111D), VA Medical Center, Minneapolis, Minnesota 55417, USA.
Eur J Cancer. 1995 Jul-Aug;31A(7-8):1141-4. doi: 10.1016/0959-8049(95)00163-d.
Patients who have had a colorectal adenoma resected have an increased risk of subsequent cancer and may benefit from follow-up surveillance. Surveillance strategies should be tailored to the assessed risk of each individual patient. A number of long-term follow-up studies indicate that the risk of metachronous neoplasia is higher if on index colonoscopy there were multiple (> or = 2) adenomas, or if any adenoma was large (> or = 1 cm), contained villous tissue or severe dysplasia, or if the patient had a family history of colorectal neoplasia. Data from the U.S. National Polyp Study indicate that polyp resection and follow-up surveillance greatly reduces the incidence of metachronous cancer, and that the first follow-up colonoscopy does not need to be performed for 3 years. Current data have been incorporated into a comprehensive consensus practice guideline.
已切除大肠腺瘤的患者后续患癌风险增加，可能受益于随访监测。监测策略应根据每位患者评估的风险进行调整。多项长期随访研究表明，如果初次结肠镜检查时存在多个（≥2个）腺瘤，或任何腺瘤较大（≥1 cm）、含有绒毛组织或重度发育异常，或患者有大肠肿瘤家族史，则异时性肿瘤的风险较高。美国国家息肉研究的数据表明，息肉切除和随访监测可大大降低异时性癌症的发生率，且首次随访结肠镜检查无需在3年内进行。目前的数据已纳入一份全面的共识实践指南。
