Triantafyllou K, Papatheodoridis G V, Paspatis G A, Vasilakaki T H, Elemenoglou I, Karamanolis D G
Department of Gastroenterology, Tzaneion General Hospital of Piraeus, Greece.
Hepatogastroenterology. 1997 Mar-Apr;44(14):533-8.
BACKGROUND/AIMS: In order to reduce the number of colonoscopies performed for the surveillance of patients after polypectomy, suitable predictors of adenomas recurrence are needed. The aim of this study was to find predictors of the early development of metachronous adenomas and specifically of advanced ones.
Forty-four patients underwent total colonoscopy 24-26 months after initial endoscopic polypectomy. All polyps were endoscopically removed and an adenoma was considered as advanced if the diameter was > 1 cm and/or villous component and/or severe dysplasia were present.
Metachronous adenomas were detected in 16 (36.4% patients. Five (11.4%) of them had advanced metachronous adenomas. Early recurrence of adenomas was significantly correlated with the total number of indices adenomas (p = 0.027). On the contrary, the presence of metachronous adenomas was not related to any of the patients' characteristics nor to the site and the histology of the indices adenomas. The development of advanced metachronous adenomas during the same period was significantly correlated with patients' age, as it was observed only in patients aged > or = 60 years (5/21 or 23.8%) and in none of the patients aged < 60 years (Odds ratio: 15.7, p = 0.02). Logistic regression analysis revealed that patient's age was the only significant predictor of the early development of advanced metachronous adenomas (beta = 0.40, p = 0.02) and that the number of the indices adenomas was the only significant predictor for the recurrence of all adenomas (beta = 1.59, p = 0.02).
背景/目的：为了减少息肉切除术后患者监测所需的结肠镜检查次数，需要合适的腺瘤复发预测指标。本研究的目的是寻找异时性腺瘤早期发生，特别是高级别异时性腺瘤发生的预测指标。
44例患者在初次内镜下息肉切除术后24 - 26个月接受全结肠镜检查。所有息肉均经内镜切除，直径>1 cm和/或存在绒毛成分和/或重度不典型增生的腺瘤被视为高级别腺瘤。
16例（36.4%）患者检测到异时性腺瘤。其中5例（11.4%）患有高级别异时性腺瘤。腺瘤的早期复发与索引腺瘤总数显著相关（p = 0.027）。相反，异时性腺瘤的存在与患者的任何特征、索引腺瘤的部位及组织学均无关。同期高级别异时性腺瘤的发生与患者年龄显著相关，因为仅在年龄≥60岁的患者中观察到（5/21或23.8%），而年龄<60岁的患者中无一例发生（比值比：15.7，p = 0.02）。逻辑回归分析显示，患者年龄是高级别异时性腺瘤早期发生的唯一显著预测指标（β = 0.40，p = 0.02），索引腺瘤数量是所有腺瘤复发的唯一显著预测指标（β = 1.59，p = 0.02）。
