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源于一级亲属中有结直肠癌家族史而年龄在40-49岁接受结肠镜筛查的个体中腺瘤与高危腺瘤的发病率

发布日期:2014-1-29 12:40:14 文章来源:GIE(July,2011) 作者次数:1172
    源于一级亲属中有结直肠癌家族史而年龄在40-49岁接受结肠镜筛查的个体中腺瘤与高危腺瘤的发病率
     
    背景
    根据目前的指导方针,建议有结直肠癌(CRC)一级亲属者应该至少在40岁进行筛检。但关于这些患者腺瘤与高危腺瘤发病率的资料很少。
    目的
    为调查因CRC家族史接受结肠镜检查的,年龄在40-49岁个体的腺瘤与高危腺瘤发病率
    设计方案
    回顾性病例审查。
    患者
    患者年龄在40-49岁之间,无腺瘤与高危腺瘤临床症状,但他们有一位患CRC一级亲属,所以他们于1999年至2009年期间在密歇根大学第一次接受结直肠镜筛检 。  
    主要评价指标
    腺瘤(任何大小)、高危腺瘤的发病率,与腺瘤相关的风险因素。
    结果
    640例研究对象中,任何尺寸腺瘤的发病率是15.4%,高危腺瘤为3.3%。患CRC一级亲属中,低于60岁的腺瘤发病率比大于60岁的低,比例分别为12.4% ,19%(P = 0.034)。男性性行为(优势比为2.6;95%置信区间为1.06-4.4)和增长的年龄(优势比为1.16;95%置信区间为1.03-1.31)与腺瘤相关。
    局限性
    有限的危险因素暴露资料和不充分的标本尺寸去评估高危腺瘤的危险因素。
    结论
    因有患CRC一级亲属,年龄在40-49岁间而接受结肠镜筛查的患者,他们患腺瘤和高危腺瘤概率低。还需有进一步研究去确定这类型人群是否比平均风险人群有较高的腺瘤发病率。
     
    缩写:
    AA为高危腺瘤,BMI为身体质量指数,CRC为结直肠癌,FDR为一级亲属,OR为优势比,RR相关危险因子。
     
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    Prevalence of any size adenomas and advanced adenomas in 40- to 49-year-old individuals undergoing screening colonoscopy because of a family history of colorectal carcinoma in a first-degree relative
     
    Background
    Per current guidelines, patients with a first-degree relative (FDR) with colorectal cancer (CRC) should get screened at least at age 40. Data about the prevalence of adenomas and advanced adenomas (AAs) in these patients are lacking.
    Objective
    To examine the prevalence of adenomas and AAs in 40- to 49-year-old individuals undergoing screening colonoscopy for family history of CRC.
    Design
    Retrospective chart review.
    Patients
    Asymptomatic patients 40 to 49 years of age undergoing their first screening colonoscopy at the University of Michigan during the period 1999 to 2009 because of an FDR with CRC.
    Main Outcome Measurements
    Prevalence of adenomas (any size), AAs, and risk factors associated with adenomas.
    Results
    Among 640 study patients, the prevalence of adenomas (any size) was 15.4% and 3.3% for AAs. Adenoma prevalence was lower if the FDR with CRC was younger than 60 years of age versus an FDR with CRC older than 60 years of age (12.4% vs 19%, P = .034). Male sex (odds ratio 2.6; 95% CI, 1.06-4.4) and advancing age (odds ratio 1.16; 95% CI, 1.03-1.31) were associated with adenomas.
    Limitations
    Limited data on risk factor exposure and insufficient sample size to assess risk factors for AAs.
    Conclusions
    Among 40- to 49-year-old patients undergoing screening colonoscopy because of an FDR with CRC, the prevalence of adenomas and AAs is low. Further research should determine whether these individuals have a higher prevalence of adenomas compared with average-risk individuals.
     
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