Gastroenterology:腺瘤分类与结直肠癌风险

2020-03-17 MedSci原创 MedSci原创

在长达14年的随访中,高风险腺瘤人群的结直肠癌和相关死亡的风险增加,而低风险腺瘤人群无额外风险,本研究支持早期结肠镜检查在肠道肿瘤预防的应用

目前腺瘤切除后结直肠癌(CRC)和CRC相关死亡的长期风险研究尚不充分。近日研究人员利用大型的、基于社区的综合保健研究数据,对这一问题进行了考察。

从2004年到2010年,21个医疗中心的参与者接受了基线结肠镜检查,检查结果分为无腺瘤、低风险腺瘤或高风险腺瘤,参与者随访至出现首次CRC诊断、死亡、退出或直至2017年12月31日。采用Cox回归调整混杂因素,比较高风险、低风险腺瘤组与无腺瘤组的CRC和相关死亡风险。

64422人参与研究,其中女性占54.3%,平均年龄61.6岁,平均随访时间为8.1年。与无腺瘤组(45881人)相比,高风险腺瘤组(7563人)有较高的CRC(HR:2.61)及相关死亡(HR:3.94)风险,而低风险腺瘤组名患者(10978人)的CRC(HR:1.29)或相关死亡风险(HR:0.65)没有显著增加。

在长达14年的随访中,高风险腺瘤人群的结直肠癌和相关死亡的风险增加,而低风险腺瘤人群无额外风险,本研究支持早期结肠镜检查在肠道肿瘤预防的应用。

原始出处:

Jeffrey K. Lee et al. Long-term Risk of Colorectal Cancer and Related Death After Adenoma Removal in a Large, Community-based Population. Gastroenterology. March 2020.

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    2020-11-03 474576351

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    2020-12-08 许安
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    2020-08-13 Jessica

    推迟肠镜检查1-2小时是什么意思呢?#肠镜检查#

    0

  5. 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  9. 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    2020-03-17 1485440fm82暂无昵称

    很有意义

    0

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由此可见,与不进行手术的肥胖患者相比,进行减肥手术的患者发生结直肠癌的风险降低了35%。

Eur Heart J:抗凝治疗房颤患者胃肠道出血与结直肠癌风险

由此可见,在接受抗凝治疗的AF患者中,胃肠道出血导致发生结直肠癌的绝对风险升高。GI出血不应作为OAC治疗的良性结局而排除,而应始终评估潜在的恶性病因。

2020 NICE指南:结直肠癌(NG.151)

2020年1月,英国国家卫生与临床优化研究所 (NICE)发布了结直肠癌管理指南,主要内容涵盖了年龄≥18岁人群结直肠癌的管理,主要目的是通过结直肠癌患者局部疾病的管理和继发性疾病的管理改善患者的生活质量和生存。

Br J Surg:腹腔镜结直肠癌手术持续腹横肌切口平面阻滞、硬膜外镇痛或病人自控镇痛的随机临床研究

腹腔镜结直肠癌术后最佳镇痛方案尚不清楚。本研究旨在探讨腹腔镜结直肠癌手术持续腹横肌切口平面阻滞、硬膜外镇痛或病人自控镇痛的镇痛效果。

Gastroenterology:腺瘤切除后结直肠癌高风险评估

研究认为,依据直径≥20 mm的腺瘤和高度异型增生这2个结直肠癌高风险新标准,在不增加腺瘤患者癌变风险的情况下,可大幅度减少需强化监测患者数量,避免过度诊疗