结肠镜后结肠癌患者和内镜特征-一例对照研究
Sonja P Dawsey1, Pamela M Vacek2, Eric K Ganguly1
1Division of Gastroenterology and Hepatology, University of Vermont Medical Center, Burlington, Vermont.
结肠镜后结肠直肠癌 (PCCRC) 的风险与在结肠镜检查期间发现的癌前多和高风险腺瘤有关. 不遵守监测指南也会增加PCCRC的风险,强调需要提高内镜质量和遵守.
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:
- 结肠镜检查是预防结肠直肠癌 (CRC) 的关键工具,但它也有局限性.
- 结肠镜后CRC (PCCRC) 是指在结肠镜检查后诊断的CRC.
- PCCRC被归类为非间歇性或间歇性癌症.
研究的目的:
- 确定与PCCRC相关的风险因素.
- 为了比较非间隔和间隔PCCRC之间的风险.
- 评估内镜质量和准则遵守对PCCRC开发的影响.
主要方法:
- 进行了一项回顾性病例控制研究.
- 来自佛蒙特州瘤登记处的数据确定了54例PCCRC病例和162个匹配的对照.
- 病例被分为非间隔和间隔PCCRC组.
主要成果:
- PCCRC风险,特别是非间歇性PCCRC,与有过的息肉,状状息肉和高风险腺瘤 (HRA) 相关.
- 带有大息肉或HRA的索引结肠镜显著增加了PCCRC风险.
- 美国胃肠道学会监测指南的不遵守与增加PCCRC和间隔PCCRC风险有关.
结论:
- 传统的CRC风险因素,如癌前多和HRA,与整体和非间隔PCCRC有关.
- 间隔PCCRC与这些传统风险因素无关.
- 内镜质量和遵守监测指南是预防PCCRC的关键因素,大约30%的PCCRC归因于内镜质量.
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