Risk of adenoma recurrence after polypectomy in patients younger than 50 years vs. 50 years old and over with diminutive or small adenomas.
Risk of adenoma recurrence after polypectomy in patients younger than 50 years vs. 50 years old and over with diminutive or small adenomas.
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DOI：
10.3389/fonc.2022.823263
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发表时间：
2022
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
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目前的研究表明，息肉复发发生在结肠腺瘤息肉切除术(AP)后，但50岁以上患者和50岁以下患者之间复发风险的差异尚未得到明确研究。490例AP后患者入选本研究。按年龄(50岁或≥50岁)进行分类，并根据腺瘤的基本特征进一步分类：第1组：1~2个非晚期腺瘤(NAAS)，大小1~5 mm；第2组：≥3NAAS，1~5 mm；第3组：1~2NAAS，6~9 mm；第4组：≥3NAAS，6~9 mm；第5组：晚期腺瘤。在平均2.52年的随访期间(50岁的≥患者为2.51年，50岁的患者为2.55年)，147例患者(30.0%)出现复发。总体而言，50岁的≥患者发生急性胰腺炎后复发的风险比(HR)高于50岁的患者(HR，1.774，P=0.003)。在50岁以上的患者中，NAA复发的HR(第2~5组分别为0.744(P=0.773)、3.885(P=0.007)、5.337(P=0.003)和3.334(P=0.015)。对于50岁的≥患者，复发的HR(第2~5组)分别为1.033(P=0.965)、1.250(P=0.405)、2.252(P=0.015)和1.887(P=0.009)。对于G1，≥患者50岁的复发风险(HR，2.932，P=0.011)显著高于50岁患者；对于G2-G5，两个年龄组的风险相似(P>；0.05)。对于直径1~5 mm、<3个NAA的50岁以上患者，其复发率低于50岁、结肠镜检查结果相同的≥患者。当腺瘤大小为≥5 mm或个数超过3个时，其复发风险与≥50岁患者相似。
Current studies have shown that polyp recurrence occurs after colonic adenomas polypectomy (AP), but the difference in recurrence risk between patients in patients older than 50 years and younger than 50 years has not been clearly studied. 490 patients after AP were enrolled in the study. The patients were classified according to age (<50 years old or ≥50 years old), and then further categorized according to the baseline adenoma characteristics: Group 1: 1–2 non-advanced adenomas (NAAs) 1–5 mm in size; Group 2: ≥3 NAAs, 1–5 mm; Group 3: 1–2 NAAs, 6–9 mm; Group 4: ≥3 NAAs, 6–9 mm; and Group 5: advanced adenomas. During a mean follow-up interval of 2.52 years (2.51 years for ≥50 years old and 2.55 years for patients <50 years old), NAA recurrence was detected in 147 patients (30.0%). Overall, the hazard ratio (HR) for NAA recurrence after AP was higher in patients ≥50 years old than that in patients <50 years old (HR, 1.774, P = 0.003). For patients <50 years old, HRs (Group 2-5 vs. G1, respectively) for NAA recurrence were 0.744 (P = 0.773), 3.885 (P = 0.007), 5.337 (P = 0.003), and 3.334 (P = 0.015). For patients ≥50 years old, HRs (Group 2-5 vs. G1, respectively) for NAA recurrence were 1.033 (P = 0.965), 1.250 (P = 0.405), 2.252 (P = 0.015), and 1.887 (P = 0.009). For G1, the risk of NAA recurrence was significantly higher in patients ≥50 years old (HR, 2.932, P = 0.011) than that in patients <50 years old; for G2–G5, the risk was similar in the two age groups (P > 0.05). For patients <50 years old with less than 3 NAAs that are 1–5 mm in size, the recurrence rate of NAA is less than that of patients ≥50 years old with the same index colonoscopy findings. When the adenomas are ≥5 mm, or their number exceeds 3, they have similar recurrence risk as that for patients ≥50 years old.
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影响因子：
29.4
作者：
Martínez ME;Baron JA;Lieberman DA;Schatzkin A;Lanza E;Winawer SJ;Zauber AG;Jiang R;Ahnen DJ;Bond JH;Church TR;Robertson DJ;Smith-Warner SA;Jacobs ET;Alberts DS;Greenberg ER
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