在便免疫化学测试中切除息肉后,结肠直肠癌风险基于查
D E F W M van Toledo1,2,3, J E G IJspeert1,2,3, M C W Spaander4
1Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
EClinicalMedicine
|August 2, 2023
概括
患有高风险状息肉的个体,特别是当与高风险腺瘤同时发生时,面临甲时性结直肠癌 (CRC) 的风险增加. 这凸显了在多叶切除术后需要量身定制的监测策略的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 结肠镜监测间隔对于预测聚片切除后的甲时结肠直肠癌 (CRC) 风险至关重要.
- 准确的风险分层是具有挑战性的,因为每位患者的多重息肉的常见发生.
- 这项研究调查了基于多重体亚型和同时出现的发现的CRC风险.
研究的目的:
- 评估与特定的多亚型及其组合相关的超慢性CRC风险.
- 完善风险估计模型,以进行多角切除术后的监测.
- 为监督指南提供基于证据的建议.
主要方法:
- 在荷兰CRC查计划 (2014-2020) 中使用了253,833次查结肠镜的数据.
- 采用考克斯回归分析,将基线结肠镜检查结果与甲时性CRC发展联系起来.
- 根据高风险状息肉和高风险腺瘤的存在或不存在,将患者分类为子组.
主要成果:
- 在36个月的中位数随访期间,发现了504个超慢性CRC.
- 患有高风险状息肉的个体 (单独或高风险腺瘤) 显著增加了CRC风险 (HR 1.70-2.00).
- 单独高风险腺瘤与CRC风险的适度增加有关 (HR 1.22).
结论:
- 高风险状息肉和高风险腺瘤的同时出现显著增加了元慢性CRC的风险.
- 即使没有高风险腺瘤,存在高风险的状息肉也会增加CRC风险.
- 这些发现支持根据特定的多重体特征来完善多重体切除术后监测指南.
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