在检测出近位多,腺瘤和它们的组合后,发生全位多性晚期瘤的风险
Widad Safih1, Daniel von Renteln1,2, Ioana Popescu Crainic1
1Division of Gastroenterology, Montreal University Hospital Research Center (CRCHUM), Montreal, QC H2X 0C1, Canada.
Journal of the Canadian Association of Gastroenterology
|September 3, 2025
概括
靠近性多和腺瘤的结合显著增加了晚期甲基慢性瘤 (TMAN) 的风险. 这一发现强调了在结肠镜检查期间识别两种多类型对于准确的风险评估的重要性.
科学领域:
- 胃肠病学
- 预防结肠直肠癌
- 内镜检查
背景情况:
- 形形病变 (SSL) 与晚期甲基慢性瘤 (TMAN) 有关.
- 亲近性多发性息肉 (HP) 对TMAN风险的影响不太清楚.
- 当发现腺瘤时,近端HP可能表明更高的风险.
研究的目的:
- 在后续结肠镜检查中评估TMAN的风险.
- 在初始结肠镜检查期间,根据近端HPs,腺瘤或两者的存在来评估TMAN风险.
主要方法:
- 从2014年至2015年的结肠镜记录的回顾.
- 在最终分析中包括764名患者.
- 主要结局:随访时的TMAN (晚期腺瘤或高风险SSL).
主要成果:
- 与单独的腺瘤 (19%) 或带有远端HP的腺瘤 (19%) 相比,近端HP和腺瘤患者的TMAN风险显著增加 (30.5%).
- 临近HP和腺瘤的组合显示TMAN风险 (HR=3. 6) 比单独临近HP高 (13. 9%).
- 在单独的腺瘤和单独的近端HP之间没有发现显著的TMAN风险差异.
结论:
- 邻近HP和腺瘤的同时存在大大增加了TMAN的风险.
- 需要进一步研究以了解这些多组合对结肠镜后结肠直肠癌 (CRC) 的影响.
- 对于个性化监测策略来说,准确识别近端HP和腺瘤至关重要.
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