Increased Prevalence of Colorectal Neoplasia in Korean Patients with Sporadic Duodenal Adenomas: A Case-Control Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Recent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects. Methods: This retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy fi ndings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations. Results:Between 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%)of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confi dence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19%vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were signifi cantly more common in patients with sporadic duodenal adenomas than in healthy control subjects. Conclusions: Compared with healthy individuals, patients with sporadic duodenal adenomas were at a signifi cantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies.
Abstract
Background/Aims: Recent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects. Methods: This retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy fi ndings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations. Results:Between 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%)of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confi dence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19%vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were signifi cantly more common in patients with sporadic duodenal adenomas than in healthy control subjects. Conclusions: Compared with healthy individuals, patients with sporadic duodenal adenomas were at a signifi cantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies.
참고문헌 (29)
- Lynch HT, "Hereditary colorectal cancer", N Engl J Med, 348, pp.919~932 (2003)
- Höchter W, "Duodenal polyps: incidence, histologic substrate and significance", Dtsch Med Wochenschr, 109, pp.1183~1186 (1984)
- Jepsen JM, "Prospective study of prevalence and endoscopic and histopathologic characteristics of duodenal polyps in patients submitted to upper endoscopy", Scand J Gastroenterol, 29, pp.483~487 (1994)
- Murray MA, "Sporadic duodenal adenoma is associated with colorectal neoplasia", Gut, 53, pp.261~265 (2004)
- Ramsoekh D, "Sporadic duodenal adenoma and the association with colorectal neoplasia: a case-control study", Am J Gastroenterol, 103, pp.1505~1509 (2008)
- Krukowski ZH, "Operative management of tubulovillous neoplasms of the duodenum and ampulla", Br J Surg, 75, pp.150~153 (1988)
- Galandiuk S, "Villous tumors of the duodenum", Ann Surg, 207, pp.234~239 (1988)
- Perzin KH, "Adenomas of the small intestine: a clinicopathologic review of 51 cases and a study of their relationship to carcinoma", Cancer, 48, pp.799~819 (1981)
- Ford AC, "Sporadic duodenal adenoma and colorectal neoplasia", Gut, 53, pp.1056~1057 (2004)
- Pequin P, "Patients with sporadic duodenal adenoma are a high-risk group for advanced colorectal neoplasia: results of a case-control study", Aliment Pharmacol Ther, 26, pp.277~282 (2007)
- Apel D, "High frequency of colorectal adenoma in patients with duodenal adenoma but without familial adenomatous polyposis", Gastrointest Endosc, 60, pp.397~399 (2004)
- Dariusz A, "Increased prevalance of colorectal adenoma in patients with sporadic duodenal adenoma", Eur J Gastroenterol Hepatol, 21, pp.816~818 (2009)
- Lagarde S, "Increased risk of colonic neoplasia in patients with sporadic duodenal adenoma", Gastroenterol Clin Biol, 33, pp.441~445 (2009)
- Chong KC, "Benign duodenal tumors", Hepatogastroenterology, 47, pp.1298~1300 (2000)
- Hu ZM, "Diagnosis and treatment of benign duodenal tumor", Zhonghua Wei Chang Wai Ke Za Zhi, 8, pp.35~37 (2005)
- Matsuura H, "Clinicopathological features of elevated lesions of the duodenal bulb", J Surg Oncol, 45, pp.79~84 (1990)
- Hirasawa R, "Clinicopathologic features and endoscopic resection of duodenal adenocarcinomas and adenomas with the submucosal saline injection technique", Endosc, 46, pp.507~513 (1997)
- Goh KL, "Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy", Aliment Pharmacol Ther, 22, pp.859~864 (2005)
- Yiu HY, "Increasing colorectal cancer incidence rates in Japan", Int J Cancer, 109, pp.777~781 (2004)
- Seok-JunYoon, "Estimation of the Burden of Major Cancers in Korea", Journal of Korean Medical Science, 17(5), pp.604~610 (2002), 대한의학회
- Schlemper RJ, "The Vienna classification of gastrointestinal epithelial neoplasia", Gut, 47, pp.251~255 (2000)
- Choe JW, "Screening colonoscopy in asymptomatic average-risk Koreans: analysis in relation to age and sex", J Gastroenterol Hepatol, 22, pp.1003~1008 (2007)
- Lieberman DA, "Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380", N Engl J Med, 343, pp.162~168 (2000)
- Betés M, "Use of colonoscopy as a primary screening test for colorectal cancer in average risk people", Am J Gastroenterol, 98, pp.2648~2654 (2003)
- Schoenfeld P, "Colonoscopic screening of average-risk women for colorectal neoplasia", N Engl J Med, 352, pp.2061~2068 (2005)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality and Survival in 2005", Journal of Korean Medical Science, 24(6), pp.995~1003 (2009), 대한의학회
- Iida M, "Natural history of duodenal lesions in Japanese patients with familial adenomatosis coli (Gardner’s syndrome)", Gastroenterology, 96(5 Pt 1), pp.1301~1306 (1989)
- Spigelman AD, "Evidence for adenomacarcinoma sequence in the duodenum of patients with familial adenomatous polyposis", J Clin Pathol, 47, pp.709~710 (1994)
- Schulmann K, "HNPCC-associated small bowel cancer: clinical and molecular characteristics", Gastroenterology, 128, pp.590~599 (2005)