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IF 4.5 2区医学 Q1 ONCOLOGY

Cancers Pub Date : 2024-11-30 DOI:10.3390/cancers16234021

Danielle Mirda, Michaela Dungan, Yue Ren, Hongzhe Li, Bryson W Katona

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引用次数: 0

摘要

背景：林奇综合征（LS）的预期和最佳腺瘤检出率（ADR）尚不明确。本研究旨在确定林奇综合征队列中的腺瘤检出率、总体结直肠肿瘤检出率（CNDR）、近端锯齿状检出率（PSDR）和 CRC 检出率（CRCDR）：对2001年5月至2023年9月期间在一家三级医疗中心接受评估的LS患者（n = 542）进行了回顾性研究。研究人员收集了手术和病理报告中的数据，以及相关的人口统计学、临床病史和家族史数据。采用费舍尔精确检验和 Kruskal-Wallis 检验来评估与结直肠肿瘤相关的因素：在542名LS患者中，有352人符合纳入标准，他们的1296次结肠镜/乙状结肠镜检查被用于分析。该群体主要为女性（64.5%）、白人（87.5%）和有私人保险者（76.1%），不同基因型的分布接近均匀。CNDR为27.9%，ADR为21.4%，PSDR为7.7%，CRCDR为1.5%。高龄、医疗保险、既往结肠切除术和既往非 CRC 病史与 CNDR 和 ADR 的增加显著相关（p < 0.05）。PSDR 随年龄增长而保持不变。PSDR与基因型、生理性别、种族、吸烟、体重指数、阿司匹林的使用和家族史均无关联：结论：尽管经常进行结肠镜/乙状结肠镜检查，LS 患者的结直肠肿瘤发生率仍然很高，这主要是由于随着年龄的增长，腺瘤的检出率增加。肿瘤发生率可作为内镜医师为LS患者进行结肠镜/乙状结肠镜检查时的有用 "参考率"。不过，还需要进一步研究来确定肿瘤发生率是否能预测 LS 患者的 CRC 风险和结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Colorectal Neoplasia Detection Rates in Lynch Syndrome.

Background: The expected and optimal adenoma detection rate (ADR) is not well characterized in Lynch syndrome (LS). The aim of this study is to determine the ADR, the overall colorectal neoplasia detection rate (CNDR), proximal serrated detection rate (PSDR), and CRC detection rate (CRCDR) in an LS cohort.

Methods: A retrospective study was performed of individuals with LS who were evaluated at a single tertiary care center from May 2001 to September 2023 (n = 542). Data from procedure and pathology reports were collected along with relevant demographic, clinical history, and family history data. Fisher's exact test and the Kruskal-Wallis test were used to assess factors associated with colorectal neoplasia.

Results: Amongst 542 individuals with LS, 352 met the inclusion criteria, and their 1296 colonoscopies/sigmoidoscopies were used for analysis. The cohort was primarily female (64.5%), white (87.5%), and privately insured (76.1%), with a near even distribution across genotypes. CNDR was 27.9%, ADR was 21.4%, PSDR was 7.7%, and CRCDR was 1.5%. Advanced age, Medicare insurance, prior colonic resection, and prior history of non-CRC were significantly associated with an increased CNDR and ADR (p < 0.05). PSDR remained constant with age. There was no association with genotype, biological sex, race, smoking, BMI, aspirin use, nor family history.

Conclusions: Despite frequent colonoscopies/sigmoidoscopies, individuals with LS maintain a high rate of colorectal neoplasia, primarily driven by increased detection of adenomas with advancing age. Neoplasia rates may serve as helpful "ballpark rates" for endoscopists performing colonoscopies/sigmoidoscopies in LS. However, further studies need to determine whether neoplasia rates are predictive of CRC risk and outcomes in LS.

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来源期刊

Cancers Medicine-Oncology

CiteScore

8.00

自引率

9.60%

发文量

5371

审稿时长

18.07 days

期刊介绍： Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.