Delhougne B, Deneux C, Abs R, Chanson P, Fierens H, Laurent-Puig P, Duysburgh I, Stevenaert A, Tabarin A, Delwaide J, Schaison G, Belaïche J, Beckers A
Department of Gastroenterology, University of Liège, Belgium.
J Clin Endocrinol Metab. 1995 Nov;80(11):3223-6. doi: 10.1210/jcem.80.11.7593429.
Patients with acromegaly are reported to be at risk of developing adenomatous colonic polyps, which are considered to be preneoplastic lesions. This assumption is, however, usually drawn from results obtained in rather small series of patients or without a control group. We, therefore, undertook a prospective colonoscopic and pathological study comprising 103 acromegalic patients and 138 nonacromegalic control subjects referred for irritable bowel syndrome. The prevalence of adenomatous colonic polyps was significantly increased in acromegalic patients compared to that in control subjects (22.3% vs. 8.0%; P = 0.0024). The significance was similarly present in male acromegalic patients (28.6% vs. 5.5% in male control subjects; P = 0.0026), but was absent in female acromegalic patients. The prevalence of colonic polyps was also significantly increased in the group of acromegalic patients under 55 yr of age (20.0% vs. 3.0% in the control group of the same age; P = 0.0026). Other characteristics of adenomatous colonic polyps in acromegaly were the multiplicity and the presence proximal to the splenic flexure. No difference in the duration of acromegaly was found between patients with or without adenomatous polyps. The prevalence of hyperplastic colonic polyps was also significantly increased to 24.3% in acromegalic patients vs 4.4% in control subjects (P < 0.001). In conclusion, in view of the increased incidence of adenomatous colonic polyps, colonoscopy should be part of the follow-up examination in acromegaly.
据报道，肢端肥大症患者有发生结肠腺瘤性息肉的风险，而结肠腺瘤性息肉被认为是癌前病变。然而，这一假设通常是基于少数患者的研究结果或未设对照组的研究得出的。因此，我们进行了一项前瞻性结肠镜检查和病理研究，纳入了103例肢端肥大症患者和138例因肠易激综合征转诊的非肢端肥大症对照者。与对照组相比，肢端肥大症患者结肠腺瘤性息肉的患病率显著升高（22.3%对8.0%；P = 0.0024）。男性肢端肥大症患者中也存在同样的显著性差异（男性对照组为5.5%，男性肢端肥大症患者为28.6%；P = 0.0026），但女性肢端肥大症患者中不存在此差异。55岁以下的肢端肥大症患者组中结肠息肉的患病率也显著升高（同年龄对照组为3.0%，肢端肥大症患者组为20.0%；P = 0.0026）。肢端肥大症患者结肠腺瘤性息肉的其他特征包括多发性和脾曲近端存在息肉。有或无腺瘤性息肉的患者在肢端肥大症病程上未发现差异。增生性结肠息肉的患病率在肢端肥大症患者中也显著升高至24.3%，而对照组为4.4%（P < 0.001）。总之，鉴于结肠腺瘤性息肉的发病率增加，结肠镜检查应成为肢端肥大症随访检查的一部分。
