Familial juvenile polyposis coli; increased risk of colorectal cancer.
Familial juvenile polyposis coli; increased risk of colorectal cancer.
复制标题
家族性幼年性大肠杆菌息肉病；
作者：
H. Jarvinen;K. Franssila
本文报告了一个家族和一个孤立的幼年型结肠息肉病的六例患者。结肠息肉的组织学改变形成了一个从幼年息肉，通过局灶性到广泛的腺瘤性改变，腺癌的光谱。一名49岁的患者患有结肠腺癌，另一名33岁的患者患有直肠息肉和转移性癌症，尽管原发肿瘤未找到，但仍怀疑这一点。另外两名患者，年龄分别为19岁和41岁，在幼年息肉中有严重的腺瘤性发育不良。4例患者还患有胃十二指肠息肉。目前的研究结果显然与以前的观点相矛盾，即青少年结肠息肉病不是癌前病变，很少需要手术治疗。由于其他最近的报告也描述了幼年性息肉中肿瘤性变化的频繁发生，因此建议在20岁左右进行结肠切除术和回肠直肠造口术作为幼年性结肠息肉病的治疗选择，如家族性结肠腺瘤病患者。理想情况下，随访应包括定期胃镜检查和直肠残端检查。
Six patients from one family and one solitary patient with juvenile polyposis coli are described. The histological changes in colonic polyps formed a spectrum from juvenile polyps, through focal to extensive adenomatous change, to adenocarcinomas. One patient aged 49 years had an adenocarcinoma of the colon and in another, aged 33, with rectal polyps and metastatic cancer this was suspected although the primary tumour was not located. Two additional patients, aged 19 and 41 years, had severe adenomatous dysplasia in a juvenile polyp. Four patients also had gastroduodenal polyps. The present findings clearly contradict the previous view that juvenile polyposis coli is not premalignant and only rarely needs surgical treatment. As other recent reports also describe frequent occurrence of neoplastic changes in juvenile polyps, colectomy, and ileorectostomy at the age of about 20 years is recommended as the treatment of choice for juvenile polyposis coli, as in patients with familial adenomatosis coli. Follow up should ideally include gastroduodenoscopy and inspection of the rectal remnant at regular intervals.