1970例健康体检者结肠镜检查结果分析

背景:结直肠癌是目前公认的可通过有效干预手段降低病死率的恶性肿瘤。目的:了解新疆地区健康体检人群的结直肠疾病患病情况,探讨对无症状人群进行结肠镜筛查的必要性。方法:纳入于2009年7月~2013年6月在新疆维吾尔自治区人民医院自愿接受结肠镜检查的无症状健康体检者,对其检查结果进行回顾性分析。结果:共1 970例体检者纳入研究,总体病变检出率为39.4%,其中结直肠息肉376例(19.1%),结直肠癌10例(0.5%),结肠黑变病38例(1.9%)。检出的560枚息肉中,以分布于左半结肠的管状腺瘤居多。男性息肉检出率显著高于女性(24.6%对11.2%,P0.001);息肉检出率随年龄增长呈上升趋势,≥50岁年龄段人群检出率显著高于50岁年龄段人群(25.9%对14.3%,P0.05);汉族人群息肉检出率显著高于维吾尔族和哈萨克族人群(22.6%对10.9%和10.9%,P0.05)。结论:本组无症状健康体检者的结直肠息肉检出率较高,患者分布具有明显的性别(男性)、年龄(≥50岁)、民族(汉族)特征。对50岁以上的无症状人群进行结肠镜筛查具有重要意义。     

985例结直肠癌筛查高危人群肠息肉临床特征分析

背景:结直肠息肉为消化道的常见疾病,与结直肠癌的发生、发展关系密切。目的:探讨结直肠癌筛查高危人群中肠息肉的临床特点。方法:选取2013年4月—2014年12月粪便隐血试验阳性或结直肠癌高危因素调查表评价存在高危因素并在上海市第一人民医院分院接受结肠镜检查的虹口区社区居民。分析结直肠息肉的检出率、不同性别人群、年龄段的特征,以及结直肠息肉的发病部位、形态、病理类型等特点。结果:共985例息肉患者纳入本研究,息肉总体检出率为48.7%,男性检出率明显高于女性(58.7%对38.9%;χ~2=79.788,P0.01)。不同年龄段息肉检出率差异有统计学意义(χ~2=23.820,P0.01)。左半结肠息肉检出率明显高于右半结肠(62.4%对37.6%,χ~2=190.643,P0.01)。隆起型息肉0-Ⅰ的总体检出率94.5%,平坦型息肉0-Ⅱa为48.3%。腺瘤性息肉检出率高于非腺瘤性息肉(59.3%对47.1%,χ~2=27.326,P0.01)。119例患者的两次病理结果不一致。仅17.8%息肉摘除者术后行结肠镜随访,其中62.3%息肉复发。结论:结直肠癌筛查高危人群有较高的结直肠息肉发生率,高质量的结肠镜检查和及时有效的手术可降低结直肠癌的发生。     

针对高危人群结直肠癌伺机性筛查的可行性分析

背景:对结直肠癌(CRC)及其癌前病变结直肠腺瘤(CRA)的筛查是降低CRC发病率的关键。伺机性筛查是适合中国国情的CRC筛查策略,针对高危人群的伺机性筛查可能进一步缩小筛查范围,节省卫生资源。目的:分析高危因素对CRC/CRA的预测价值,探讨针对高危人群的CRC伺机性筛查的可行性。方法:1 862例于2015年2月—2016年8月在中国人民解放军281医院接受结肠镜检查的门诊患者和健康体检者纳入研究。根据最新《中国早期结直肠癌及癌前病变筛查与诊治共识意见》中高危人群的判定标准,在检查前对受检者进行问卷调查,筛选出高危人群。以结肠镜检查结果为金标准,分析高危因素对CRC/CRA的预测价值。结果:共筛选出CRC/CRA高危个体468例(25.1%),高危人群的CRC检出率显著高于非高危人群(17.5%对0.9%,P=0.000)。高危因素预测CRC的敏感性为87.2%,特异性为78.2%,阳性预测值为17.5%,阴性预测值为99.1%,漏诊率为12.8%;对于CRC/CRA,相应数据分别为83.2%、87.0%、57.3%、96.1%和16.8%。高危因素对CRC和CRC/CRA的相对危险度(RR)分别为20.35和14.78。结论:针对高危人群的CRC伺机性筛查可行性较高,适合目前我国国情。     

无痛肠镜下腺瘤检出率的影响因素分析

[目的]探讨基于无痛肠镜背景下腺瘤检出率的影响因素。[方法]选取2016年12月~2017年3月在我院消化内镜中心行无痛结肠镜检查的患者255例,对其临床资料进行回顾性分析,分别用χ2检验或Fisher’s精确检验和多元logistic回归对可能影响腺瘤检出率的因素进行单因素及多因素分析。[结果]255例行无痛肠镜检查的患者,总的腺瘤检出率为20.78%,其中男性为23.53%,女性为18.38%。左半结肠的腺瘤检出率明显高于横结肠及右半结肠(P<0.001)。单因素分析显示:患者的年龄、退镜时间对腺瘤检出率有显著影响(P<0.001);多因素分析表明:年龄超过45岁、退镜时间>3min是腺瘤检出率的独立影响因素。[结论]无痛肠镜检查背景下,患者的年龄、退镜时间与腺瘤检出率存在密切联系。     

结直肠癌筛查发现的7 408例肠道病变临床特征及病理类型分析

目的 探讨结直肠病变患者临床与病理特征，为结直肠癌早期临床诊断与干预提供依据。 方法 基于2007至2012年海宁市32万余40～74岁目标人群结直肠癌筛查结果，对筛查检出的肠道病变进行临床特征（包括性别、年龄、大小、部位、形态、数目）及病理类型等分析探讨。 结果 共完成初筛286 470例，顺应率88.96％；完成结肠镜检查29 069例，检出肠道病变7 408例，检出率25.48％；男性检出率高于女性（32.62%比19.48%，P＜0.001）；40～49岁组检出率18.30％，70～74岁组检出率35.06％，显示年龄越大检出率越高（P＜0.001）。7 408例肠道病变中，左半结肠约占69.40%，多发性病变占37.23％，＞1.0 cm病变占19.60％。检出结直肠癌205例（早期癌161例、中晚期癌44例），进展期腺瘤1 365例，早诊率为97.20％。手术切除的5 030例病变病理提示腺瘤型及以上病变所占比重最大（63.00％）。直径＞1.5 cm病变癌变率为34.08%。 结论 在高危人群中男性肠道病变检出率明显高于女性，年龄越大检出率越高；病理类型以腺瘤所占比重最高。     

肺癌低剂量CT筛查者冠状动脉钙化检出率及危险因素分析

目的探讨肺癌低剂量CT筛查人群中冠状动脉钙化检出率及相关危险因素。方法选取2013至2016年首次在我院行肺癌低剂量CT筛查的40岁以上无症状男性2722例,年龄40~81岁,其中吸烟者1052例,非吸烟者1670例。收集相关病史及血液生化检查资料,包括年龄、体质指数、吸烟史、糖尿病史及血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血尿酸、血肌酐。采用视觉评分方法进行冠状动脉钙化评分。对不同人群钙化检出率差异进行χ2检验;冠状动脉钙化与危险因素的分析采用Spearman相关分析及多因素Logistic回归。结果 2722例中,发生冠状动脉钙化者642例(23.6%),其中轻、中、重度钙化分别占88.8%、8.9%、2.3%,平均年龄为56.7±9.8岁;无冠状动脉钙化者2080例,平均年龄为49.5±7.1岁。吸烟组冠状动脉钙化检出率高于非吸烟组(25.9%比22.2%,P=0.027)。冠状动脉钙化与年龄、吸烟、高血脂、糖尿病、血肌酐升高呈显著相关,与高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸升高无显著关联。随着年龄增长,钙化检出率逐渐增加;50岁以下者,吸烟组的钙化检出率是非吸烟组的2倍多。结论无症状肺癌低剂量CT筛查人群中,轻度冠状动脉钙化检出率较高;年龄、吸烟、高血脂、糖尿病、血肌酐升高是冠状动脉钙化的危险因素。     

佳木斯郊区老年脑卒中高危人群危险因素分析

目的分析佳木斯郊区老年脑卒中高危人群的危险因素特点。方法采用整群抽样方法对60岁及以上1 735名常住居民进行病史采集、实验室检查及体格检查,分析老年脑卒中高危人群危险因素特点。结果本研究共筛选出老年脑卒中高危人群504名,检出率为29.1%;其中男性占51.4%,女性占48.6%。危险因素检出率:高血压为91.7%,血脂异常为77.4%,高同型半胱氨酸血症为86.9%,明显超重或肥胖(体质指数≥26 kg/m~2)为53.8%,缺乏运动为54.4%,吸烟为37.3%,家族史为30.8%,糖尿病为26.2%,心房颤动为1.6%。脑卒中人群老年男性同型半胱氨酸水平、舒张压及吸烟人数高于老年女性(P0.05),老年女性三酰甘油和总胆固醇高于老年男性(P0.05)。老年男性血脂异常和吸烟史比例高于老年女性(P0.05)。结论老年脑卒中高危人群的危险因素检出率较高;不同性别吸烟、同型半胱氨酸、舒张压、血清总胆固醇和三酰甘油等比较均存在差异。     

云南省社区居民高危人群糖尿病筛查结果分析

2018年7～9月对年满35周岁,糖尿病高危人群标准的居民进行筛查。其中438名调查身高、体重、腰围、血糖及口服葡萄糖耐量(OGTT)等检测。结果葡萄糖调节受损(IGR)的检出率为43.61%(191/438),糖尿病的检出率为20.09%(88/438)。55岁以上年龄组IGR检出率高于55岁及以下各年龄组,(P0.05);65岁以上年龄组的糖尿病检出率高于65岁及以下各年龄组,(P0.05)。高危对象中体重指数(BMI)≥24kg/m~2的62.10%,腰型肥胖的比例为39.27%。结论应加强对55岁以上高危人群的监测和IGR者的随访管理。体重指数(BMI),腰围为需要重点管理因素。     

西安市社区脑卒中高危人群高同型半胱氨酸血症分布特征

目的调查西安市社区脑卒中高危人群高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)流行现状及其影响因素。方法选择2012年8~12月西安市雁塔区"卫计委脑卒中筛查与防治项目"筛查中发现的脑卒中高危者1159例,其中男性470例,女性689例,年龄<60岁445例,≥60岁714例。晨空腹采集肘静脉血,测血浆同型半胱氨酸(Hcy)水平,血浆Hcy>16μmol/L为HHcy。结果 1159例入选者中,HHcy 624例(53.84%),其中轻度增高494例(79.17%),中度增高121例(19.39%),重度增高9例(1.44%)。男性HHcy 318例,女性306例,男性HHcy患病率显著高于女性(67.66%vs 44.41%,P=0.000)。年龄≥60岁HHcy 418例,<60岁206例,年龄≥60岁HHcy患病率显著高于<60岁(58.54%vs 46.29%,P=0.000)。吸烟者HHcy患病率高于无吸烟者(61.26%vs 51.23%,P=0.003),饮酒者高于无饮酒者(63.64%vs 52.34%,P=0.009),高血压者高于血压正常者(58.10%vs 48.55%,P=0.001),高脂血症者高于血脂正常者(55.64%vs 49.23%,P=0.049),颈动脉粥样硬化者高于无颈动脉粥样硬化者(58.08%vs 48.31%,P=0.001)。年龄与HHcy相关(OR=1.44,95%CI:1.25~1.66,P=0.000)。结论西安市社区脑卒中高危人群53.84%存在HHcy,年龄是HHcy的重要危险因素。     

延安市60岁以上人群脑卒中危险因素调查分析

目的了解延安市年龄≥60岁居民脑卒中及危险因素。方法采用整群抽样的方法抽取延安市年龄≥60岁的居民27 153例进行脑卒中筛查,包括问卷调查、体格检查及实验室检查。结果本地区年龄≥60岁人群脑卒中发病率为4.4%;高危人群占16.1%;男性吸烟及低危人群检出率高于女性,高危人群、中危人群、运动缺乏、血脂异常、高血压、心房颤动/心脏瓣膜病、糖尿病、超重/肥胖、脑卒中家族史、既往短暂性脑缺血发作检出率低于女性(P0.01)。脑卒中人群年龄、吸烟、高脂血症、高血压、心房颤动/心脏瓣膜病、糖尿病、超重/肥胖、脑卒中家族史比例明显高于非脑卒中者[(71.23±7.76)岁vs (69.44±8.04)岁,26.9%vs 21.8%,24.6%vs 10.1%,63.8%vs 24.7%,12.8%vs 4.9%,12.7%vs 4.3%,16.5%vs 9.3%,8.8%vs 3.2%,P=0.000];高血压、脑卒中家族史、糖尿病为年龄≥60岁人群脑卒中的主要独立危险因素(B=1.427,B=0.712,B=0.640,P=0.000)。结论延安市年龄≥60岁人群脑卒中发病率较高,高血压、糖尿病和脑卒中家族史是本地区脑卒中最重要的危险因素。     

Recurrence and malignancy rates in a benign colorectal neoplasm patient cohort: results of a 5-year analysis in a managed care environment

OBJECTIVE: To estimate the apparent recurrence rates of benign neoplasms and the development of malignant colorectal neoplasms over a 5-yr period in a high risk managed care population. METHODS: Using the CPT and ICD-9 CM codes, a cohort of subjects with benign neoplasms were identified with a colonoscopy in 1992 from a longitudinal claims database (MarketScan). Three groups of subjects (benign neoplasms with polypectomy, benign neoplasms without polypectomy, and no neoplasms) were evaluated. Five-year recurrence rates of benign or new malignant colorectal neoplasms were determined for the baseline benign neoplasms with polypectomy and no neoplasm groups. For the benign neoplasm without polypectomy, only rates for malignancy were evaluated. RESULTS: Of 16,293 subjects at baseline, 39.50% were diagnosed with benign and 5.50% with malignant neoplasms. The 5-yr cumulative incidence of benign neoplasms in subjects without an index neoplasm (n = 8,967) was 7.92% compared to the recurrence of 40.93% in subjects with a benign neoplasm and polypectomy (n = 4,046) at baseline (p < 0.001). The 5-yr cumulative incidence rates of malignant colorectal neoplasms in the no neoplasm (n = 8,967) and benign neoplasm groups (n = 6,438) were 1.81% and 2.55%, respectively (p < 0.005). A lower 5-yr malignancy rate was observed in benign neoplasm group with polypectomy (2.17%) compared to the benign neoplasm group without polypectomy (3.18%) (p < 0.05). CONCLUSION: The high recurrence rate of benign colorectal neoplasms and a higher incidence of colorectal cancer in subjects at high risk (history of benign colorectal neoplasm) highlight a healthcare opportunity for surveillance and/or interventions to reduce the morbidity associated with colorectal neoplasms.     

Risk factors for colorectal adenomas among immediate family members of patients with colorectal cancer in Taiwan: a case-control study

OBJECTIVES: The incidence of colorectal cancer or adenoma among first-degree relatives of patients with colorectal cancer is significantly high. However, a well defined screening and surveillance consensus has not been developed for these families in Taiwan. We conducted this study to evaluate the colorectal adenoma prevalence pattern in screened immediate family members in Taiwan, and to derive implications for future screening programs. METHODS: A total of 234 immediate family members (aged 51.6 +/- 21.5 yr) of 186 patients with colorectal cancer were offered a colonoscopy. Each relative examined was then paired with two control subjects for age, sex, and symptoms. The prevalence of colorectal adenomas was then compared using multiple logistic regression analysis. RESULTS: The estimated risk of developing adenomas among immediate family members of patients with colorectal cancer was significantly increased (OR = 2.33; 95% CI, 1.43-3.78; p < 0.001). This trend was more striking for men (OR = 2.46; 95% CI, 1.40-4.31; p = 0.001). Immediate family members were at an increased risk for high-risk adenomas (> or = 1.0 cm, with a villous component, and/or with severe dysplasia) (OR = 4.5; 95% CI, 1.91-10.60; p = 0.002), and developed adenomas at an earlier age than did controls. Individuals with index cancer relatives diagnosed at < 50 yr of age or male relatives posed a higher risk of developing colorectal adenomas. CONCLUSIONS: The prevalence of colorectal adenoma in persons with a colorectal cancer family history in Taiwan is similar to that reported in Western countries. This high-risk population should be offered a screening colonoscopy beginning at 40 yr of age.     

Microsatellite Instability of Gastric and Colorectal Cancers as a Predictor of Synchronous Gastric or Colorectal Neoplasms

Background/Aims

Microsatellite instability (MSI) plays a crucial role in gastrointestinal carcinogenesis. The aim of this study was to clarify whether MSI is a useful marker for predicting synchronous gastric and colorectal neoplasms.

Methods

Consecutive patients who underwent both esophagogastroduodenoscopy and colonoscopy before the resection of gastric or colorectal cancers were included. MSI was analyzed using two mononucleotide and three dinucleotide markers.

Results

In total, 434 gastric cancers (372 microsatellite stability [MSS], 21 low incidence of MSI [MSI-L], and 41 high incidence of MSI [MSI-H]) and 162 colorectal cancers (138 MSS, 9 MSI-L, and 15 MSI-H) were included. Patients with MSI gastric cancer had a higher prevalence of synchronous colorectal cancer, colorectal adenoma, and gastric adenoma than those with MSS gastric cancers (4.8% vs 0.5%, p=0.023; 11.3% vs 3.2%, p=0.011; 3.2% vs 1.2%, p=0.00, respectively). The prevalence of synchronous colorectal adenomas was highest in MSI-L gastric cancers (19.0%), compared with MSI-H (7.3%) or MSS (3.2%) gastric cancers (p=0.002). In addition, there were no significant differences in the prevalence rates of synchronous colorectal adenoma among the MSI-H (13.3%), MSI-L (11.1%), and MSS (12.3%) colorectal cancers (p=0.987).

Conclusions

The presence of MSI in gastric cancer may be a predictor of synchronous gastric and colorectal neoplasms, whereas MSI in colorectal cancer is not a predictor of synchronous colorectal adenoma.     

结肠黑变病对结直肠息肉的影响

目的研究结肠黑变病对结肠息肉发生率、病理类型等的影响。 方法回顾性分析自2012年8月至2015年12月在我院经全结肠镜诊断的结肠黑变病98例,组成黑变病组;随机选取结肠镜诊断无结肠黑变病252例,组成非黑变病组。比较两组一般情况、结肠息肉发病率、息肉病理类型等。 结果结肠黑变病II度、III度累及全结肠的比例分别为71.0%、78.6%,高于黑变病I度的50.9%（P=0.01）。结肠黑变病组结肠息肉发现率达40.8%,远高于非结肠黑变病的23.0%（P=0.001）,而且黑变病组在横结肠、降结肠、盲肠及全结肠≥3个部位发现结肠息肉的比例均高于非黑变病组,P均<0.05,但两组息肉中腺瘤的比例分别为80%、67.9%（P=0.117）,差异无统计学意义。黑变病I、II、III度在息肉检出率、息肉病理类型的比较上,均P>0.05,差异无统计学意义。左半结肠为主型、右半结肠为主型、全结肠型黑变病在息肉检出率、息肉病理类型的比较上,也均P>0.05,差异无统计学意义。 结论结肠黑变病患者结肠息肉发生率高,需加强对结肠黑变病患者肠镜筛查,预防结直肠癌发生。结肠黑变病的病变程度、部位对结肠息肉的检出率、病理类型无影响。     

Risk of Advanced Proximal Adenoma and Cancer According to Rectosigmoid Findings in the Korean Population

Colorectal cancer is one of the leading causes of cancer death in the United States and Europe. Recently, the incidence of colorectal cancer has been increasing remarkably in Korea. To reduce the high incidence, screening of colorectal cancer in asymptomatic individuals has been advocated. Sigmoidoscopy is simpler, faster, and better tolerable than total colonoscopy, but the scope cannot reach the proximal colon segment and, therefore, may miss proximal colon cancer. In the present study, we intended to investigate the prevalence of proximal adenoma and cancer according to the findings in rectosigmoid colon and to find their risk factors. Data were collected retrospectively from 1541 consecutive patients who underwent total colonoscopy at the Department of Gastroenterology, Hanyang University, between October 2003 and December 2004. Neoplasms were classified as diminutive adenoma (≤5 mm), small adenoma (6–9 mm), advanced adenoma (≥10 mm, with villous component or high-grade dysplasia), and cancer. The sites of neoplasms were defined as rectosigmoid (rectum and sigmoid colon) and proximal (from cecum to descending colon) colon. The prevalence of advanced proximal adenoma was associated with severe rectosigmoid findings. On the other hand, the prevalence of proximal colon cancer did not show such a tendency. Among the 131 patients with proximal advanced adenoma, 66% had no neoplasm in the rectosigmoid colon. Moreover, among the 27 patients with proximal cancer, 52% had no neoplasm in the rectosigmoid colon. Multivariate logistic regression analysis revealed that age, gender, and advanced rectosigmoid adenoma were the risk factors of advanced proximal adenoma, but nothing was associated with the risk for proximal colon cancer. Advanced rectosigmoid adenoma may be the predictor of advanced proximal adenoma, especially in old males. However, nothing is related to the risk for proximal colon cancer. Therefore, colonoscopy may be more adequate for colorectal cancer screening than sigmoidoscopy in the Korean population.     

Association between white opaque substance under magnifying colonoscopy and lipid droplets in colorectal epithelial neoplasms

AIM To examine the association between white opaque substance(WOS) and histologically verified lipiddroplets in colorectal epithelial neoplasms.METHODS We reviewed colonoscopy records at our institution from 2014 to 2016 and identified cases of endoscopically or surgically resected colorectal epithelial neoplasms observed by magnifying narrow-band imaging(M-NBI) colonoscopy. Immunohistochemistry was used to stain tumors with a monoclonal antibody specific to adipophilin as a marker of lipids. The expression and distribution of adipophilin were compared between WOS-positive and WOS-negative lesions and among tumors classified by histologic type and depth of invasion.RESULTS Under M-NBI colonoscopy, 81 lesions were positive for WOS and 48 lesions were negative for WOS. The rate of adipophilin expression was significantly higher in WOS-positive lesions(95.1%) than in WOS-negative lesions(68.7%)(P = 0.0001). The incidence of deep adipophilin expression was higher in WOS-positive lesions(24.7%) than in WOS-negative lesions(4.2%)(P = 0.001). The incidence of deep expression was predominant among cancers with massive submucosal invasion(62.5%) compared to adenoma(7.2%) and high-grade dysplasia or cancers with slight submucosal invasion(12.7%)(P = 0.0001).CONCLUSION The distribution of lipid droplets may be closely associated with the visibility of WOS under M-NBI colonoscopy, and with histologic grade and depth of tumor invasion.     

大肠癌高危人群结肠镜检查追踪随访

目的：大肠癌在消化道肿瘤中预后较好，如能较早的发现和及时治疗，完全可以根治。方法：对1125例大肠癌高危人群进行结肠镜的追踪随访检查，结果：发现大肠癌37例（3．3％），其中28例（75．7％）为无淋巴结转移的早期癌，发现癌前期病变一大肠腺瘤215例（19．1％）。结论：结肠镜对大肠癌高危人群进行定期追踪检查是发现早期大肠癌和癌前期病变－腺瘤最方便、最安全、最简便的方法。     

肥胖、2型糖尿病与大肠腺瘤腺癌的相关性研究

目的 初步探讨体质量指数（BMI）、2型糖尿病与大肠腺瘤腺癌的相关性.方法 2008年7月至2009年7月间,选择年龄为20～86岁的大肠镜检查患者971例,测量身高、体重,并记录有无糖尿病及病程.根据肠镜检查及活检病理结果纳入研究组（即腺瘤腺癌组,总计471例）和正常对照组（500例）.利用多因素Logistic回归进行相关性分析.结果 调整了可能的混杂因素后,肥胖组患大肠腺瘤腺癌的危险度是正常组的2.55倍,其中肥胖组男性患大肠腺瘤腺癌的危险度是正常组的3.32倍,而女性中不同BMI指数大肠腺瘤腺癌的患病率差异无统计学意义.超重组差异无统计学意义.2型糖尿病的患者引起大肠腺瘤腺癌的危险度是无糖尿病患者的约2.10倍,其中,病程〈6年引起大肠腺瘤腺癌的危险度是病程≥6年的约3.00倍,且风险与性别无关.糖尿病合并肥胖患者患大肠腺瘤腺癌的危险度是糖尿病无合并肥胖患者的3.05倍.结论 肥胖与大肠腺瘤腺癌的发生显著相关,肥胖男性患病风险明显大于女性.2型糖尿病患者患大肠腺瘤腺癌的风险较高,且糖尿病合并肥胖的患者患大肠腺瘤腺癌的风险显著高于糖尿病无肥胖的患者.     

Differences in characteristics of colorectal neoplasm between young and elderly Thais

INTRODUCTIONColorectal cancer is one of the most common cancers worldwide. It is also the most frequent form of cancers among elderly population[1]. In contrast, colorectal cancer is considered to be a rare disease in people younger than 40 years of age[2…     

Sporadic duodenal adenoma and the association with colorectal neoplasia: a case-control study

OBJECTIVES: Sporadic duodenal adenomas are an uncommon finding. It is not clear whether patients with sporadic duodenal adenoma have a greater risk for colorectal neoplasia and should undergo colonoscopy. The aims of the present study were to estimate the prevalence of colorectal neoplasia in patients with sporadic duodenal adenoma, and to compare colorectal neoplasia rates in patients with sporadic duodenal adenomas versus those without them.
METHODS: A retrospective case-control study was conducted to identify sporadic duodenal adenoma patients using the databases of two academic and one regional hospital in the Netherlands. Colonoscopic findings in the sporadic duodenal adenoma patients were compared with those of a control group of patients who underwent both gastroduodenoscopy and colonoscopy. Furthermore, the frequency of colorectal cancer in the sporadic duodenal adenoma patients was compared with the population incidence of colorectal cancer.
RESULTS: During the period 1991–2006, 102 patients in total with sporadic duodenal adenomas were identified. Colonoscopy was performed in 49 patients (48%), and colorectal neoplasia was present in 21 of these patients (43%). There was a significantly higher rate of both colorectal neoplasia (43% vs 17%, odds ratio [OR] 3.6, 95% confidence interval [CI] 1.7–7.4) and advanced colorectal adenoma (18% vs 3%, OR 7.8, 95% CI 2.1–29.4) in the patients with sporadic duodenal adenoma compared to that in the control group. Also, the incidence of colorectal cancer was higher in sporadic duodenal adenoma patients compared to that in the population ( P = 0.02).
CONCLUSIONS: Individuals with sporadic duodenal adenomas appear to be at a significantly higher risk of colorectal neoplasia, and therefore should undergo colonoscopy.