Terzolo M, Tappero G, Borretta G, Asnaghi G, Pia A, Reimondo G, Boccuzzi A, Cesario F, Rovero E, Paccotti P
Department of Clinical and Biological Sciences, University of Turin, Italy.
Arch Intern Med. 1994 Jun 13;154(11):1272-6.
An association between acromegaly and colonic polyps has been reported, although risk factors are still uncertain.
Full colonoscopy was performed with a fiberoptic colonoscopy on 31 acromegalic patients, 11 men and 20 women aged 27 to 85 years (mean, 52.2 years), and on 236 subjects, 127 men and 109 women aged 23 to 84 years (mean, 50.1 years), referred for hemorrhoids, who were considered controls. The colonoscopic findings were evaluated in relation to demographic, clinical, and hormonal data pertaining to the two groups.
The prevalence of either adenomatous or hyperplastic polyps was higher in acromegalic patients than in controls (38% vs 14% and 26% vs 10%, respectively; P < .001, respectively). Acromegalics with and without colonic adenomas did not differ significantly in growth hormone and insulinlike growth factor I levels or duration of acromegalic disease and its status (activity or remission); however, patients with adenoma were younger (median age, 50.5 vs 59 years; range, 27 to 85 years vs 39 to 66 years; P < .05). An opposite age pattern was observed in the control group. Indeed, the prevalence of adenoma in acromegalic patients was much higher than that in controls among those less than 50 years of age (46% vs 7%, P < .001); the difference was less remarkable at older ages. Adenomatous polyps were more frequently found in male subjects, in both patients and controls (45% vs 33% [not significant] and 19% vs 9% [P < .05], respectively).
Acromegaly may carry an increased risk of colonic adenoma, especially in younger patients, who usually display more aggressive disease. A smaller increase in risk was observed in elderly patients, in whom disease is reportedly milder. We suggest that acromegalic patients should undergo screening colonoscopy.
尽管危险因素仍不明确，但已有肢端肥大症与结肠息肉之间存在关联的报道。
对31例肢端肥大症患者（11例男性，20例女性，年龄27至85岁，平均52.2岁）和236例因痔疮前来就诊的对照者（127例男性，109例女性，年龄23至84岁，平均50.1岁）进行纤维结肠镜全结肠镜检查。根据两组的人口统计学、临床和激素数据对结肠镜检查结果进行评估。
肢端肥大症患者腺瘤性或增生性息肉的患病率高于对照组（分别为38%对14%和26%对10%；P均<.001）。有和没有结肠腺瘤的肢端肥大症患者在生长激素、胰岛素样生长因子I水平、肢端肥大症病程及其状态（活动期或缓解期）方面无显著差异；然而，腺瘤患者更年轻（中位年龄50.5岁对59岁；范围27至85岁对39至66岁；P<.05）。在对照组中观察到相反的年龄模式。实际上，在年龄小于50岁的人群中，肢端肥大症患者腺瘤的患病率远高于对照组（46%对7%，P<.001）；在年龄较大者中差异不那么显著。腺瘤性息肉在男性患者和男性对照者中更常见（分别为45%对33%[无显著性差异]和19%对9%[P<.05]）。
肢端肥大症可能增加结肠腺瘤的风险，尤其是在通常表现为更具侵袭性疾病的年轻患者中。在据报道病情较轻的老年患者中观察到风险增加较小。我们建议肢端肥大症患者应接受结肠镜筛查。
