传统的状腺瘤与随后高风险的息肉和结肠直肠癌的风险有关
Yufeng Chen1,2,3,4, Georgios Polychronidis4,5,6, Yueyang Zhang4
1Department of General Surgery (Colorectal Surgery) & Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases & Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
The American journal of gastroenterology
|June 10, 2025
概括
经过传统状腺瘤 (TSA) 切除的患者面临患结直肠癌和晚期息肉的风险更高. 这种高风险在TSA移除后的三年内最为明显,这凸显了及时监测的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 结肠直肠癌研究研究
背景情况:
- 传统的状腺瘤 (TSA) 是结直肠癌 (CRC) 的公认前体.
- 在TSA切除后,患进一步结直肠瘤的确切风险尚未确定.
研究的目的:
- 为了调查结直肠瘤的风险,包括高风险的息肉和CRC,在TSAs被移除后的患者中.
- 为了评估这种增加风险的时间模式.
主要方法:
- 一个回顾性队列研究,使用大众通用布赖汉姆结肠镜队列 (2007-2023年).
- 在索引结肠镜检查中包括没有多或有TSA的参与者.
- 利用时间变化的多变量调整的考克斯比例危险模型来评估风险.
主要成果:
- 与没有息肉的患者相比,患有TSA的患者患有高风险息肉 (HR 3.31),高风险腺瘤 (HR 3.07),高风险状息肉 (HR 6.66) 和CRC (HR 7.23) 的风险明显更高.
- 高危息肉的风险在TSA切除后3年达到顶峰 (HR 10.85).
- 在TSA切除后复发的息肉经常位于靠近结肠 (54%) 并且经常有状 (69%).
结论:
- 移除TSA与结直肠瘤的风险增加有关.
- 增加的风险在TSA删除后的前三年内尤其明显.
- 这些发现支持目前的美国指导方针,建议在TSA切除后3年进行监视结肠镜检查.
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