在切除高风险形息肉后,结肠直肠癌风险低
Manuel Zorzi1, Jessica Battagello1, Claudio Barbiellini Amidei1
1Veneto Tumor Registry, Azienda Zero, Padova, Italy.
概括
在查人群中,高风险腺瘤切除后,结肠直肠癌 (CRC) 的风险增加,但在低风险腺瘤切除后,并非如此. 这一发现可能有助于优化对接受便免疫化学测试 (FIT) 的人进行监测策略.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 在便免疫化学测试 (FIT) 结肠镜检查后,晚期腺瘤的患病率很高.
- 结肠直肠癌 (CRC) 的风险增加需要进行多角切除术后的监测,这给内镜服务带来了负担.
研究的目的:
- 在低风险腺瘤 (LRA) 或高风险腺瘤 (HRA) 切除后,对FIT阳性 (FIT+) 个体进行研究后的CRC风险.
- 在查人群中确定影响CRC风险的因素.
主要方法:
- 从意大利 (2002-2017年) 的基于FIT的CRC查计划中获取数据,追踪到2021年12月.
- 根据腺瘤类型 (LRA/HRA),形态,大小,发育不良和位置分析了CRC发生率和死亡率.
- 使用考克斯回归模型对FIT+/结肠镜阴性和FIT-患者的风险进行比较.
主要成果:
- 与FIT+/结肠镜阴性相比,LRA患者的CRC发病率没有增加.
- 在HRA患者中观察到CRC发病率的显著增加 (HR, 1.53).
- 邻近位置,非形形态和HRA的高度发育不良解释了过多的CRC风险 (HR,1.85).
结论:
- 在患有HRAs的患者中,结肠直肠癌的发病率显著更高.
- 患有远端脚的息肉但没有高度形症的患者没有增加CRC风险.
- 这一观察可能会降低FIT计划中的监控负担.
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