结直肠癌患者同步高风险多的危险因素
Degao He1,2,3,4, Junguo Chen1,2,3, Xuefei Jiang2,3
1Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Frontiers in surgery
|July 9, 2024
概括
结肠直肠癌 (CRC) 患者的结肠镜检查不足,可能会错过高风险的息肉. 男性性别,年龄较大,早期瘤和特定突变 (NRAS,BRAF野生类型) 与同步高风险的息肉有关.
科学领域:
- 胃肠道学和瘤学
- 癌症研究 癌症研究
- 临床医学 临床医学
背景情况:
- 结肠直肠癌 (CRC) 诊断可能因不充分的手术前结肠镜检查而复杂化.
- 肠道阻塞或不良准备可能会导致在初次检查期间错过的息肉.
- 识别患有同步高风险息肉风险的患者对于及时干预至关重要.
研究的目的:
- 在结直肠癌 (CRC) 患者中确定与同步高风险聚体相关的风险因素.
- 为了提高CRC患者在具有挑战性的手术前结肠镜检测的多检测率.
- 为有针对性的监测策略分层CRC患者.
主要方法:
- 从2014年12月到2018年9月,对6674名CRC患者进行了回顾性分析.
- 高危的息肉定义为腺瘤/状息肉≥10毫米,或带有管状/状元件或高度发育不良.
- 后勤回归分析以确定风险因素的赔率比率 (OR).
主要成果:
- 在4659名符合条件的患者中,14.5%患有同步高风险息肉.
- 多变量分析显示男性性别 (OR=2.07),年龄≥50 (OR=2.77),和早期瘤 (OR=1.46) 是显著的危险因素.
- NRAS突变 (OR=1.66) 和BRAF野生型 (OR=2.43) 瘤也与高风险的息肉有关.
结论:
- 几种风险因素预测了CRC患者同步高风险息肉的存在.
- 患有已确定的风险因素的患者应早些时候接受结肠镜后续检查.
- 早期检测同步的息肉可以改善患者在结直肠癌管理的结果.
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