Risk and preventive factors of early‐onset colorectal neoplasms: endoscopic and histological database analysis
Risk and preventive factors of early‐onset colorectal neoplasms: endoscopic and histological database analysis
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早发性结直肠肿瘤的危险因素和预防因素：内镜和组织学数据库分析
DOI：
10.1111/jgh.16045
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发表时间：
2022
影响因子：
4.1
通讯作者：
Fujishiro Mitsuhiro
中科院分区：
文献类型：
--
作者：
Arai Junya;Aoki Tomonori;Hayakawa Yoku;Niikura Ryota;Ishibashi Rei;Suzuki Nobumi;Tsuji Yosuke;Yamada Atsuo;Ushiku Tetsuo;Fujishiro Mitsuhiro
背景和目的在西方和东方国家，早发性结直肠肿瘤的发病率一直在增加。然而，这些肿瘤在东方countries的风险和预防因素仍不清楚。MethodsThe数据的5580例患者进行结肠镜检查2016年和2021年之间进行了回顾性评价。主要结局为晚期结直肠肿瘤（ACRN），定义为晚期腺瘤（腺瘤≥10 mm，或伴有高度异型增生或绒毛成分）或腺癌。确定每个年龄组（≤50岁和>50岁）与ACRN相关的临床因素，并评估两个年龄组之间的差异。结果在1001例年龄≤50岁的患者中，94例（9.4%）发现ACRN。在这个年轻的类别中，男性（调整后的比值比[aOR]：2.34，95%置信区间[CI]：1.51-3.63）和结直肠癌家族史（aOR：2.14，95% CI：1.17-3.89）与发生ACRN的几率较高显著相关。在4579例患者（年龄>50岁）中，726例（15.9%）检测到ACRN。在老年人群中，吸烟（aOR：1.32，95%CI：1.08-1.63）与ACRN的较高风险显着相关。>3.5代谢当量（METs）的运动（aOR，0.80; 95%CI：0.67-0.96）与ACRNs.ConclusionThe早发性ACRNs的发生主要与先天因素有关，而晚发性ACRNs的发生主要与后天因素有关。结肠镜检查建议年轻男性患者，特别是那些有结肠直肠癌家族史的患者。
Background and AimThe incidence of early‐onset colorectal neoplasms has been increasing in both Western and Eastern countries. However, the risks and preventive factors for these neoplasms in Eastern countries remain unclear.MethodsThe data of 5580 patients who underwent colonoscopy between 2016 and 2021 were retrospectively evaluated. The primary outcome was advanced colorectal neoplasm (ACRN), defined as advanced adenomas (adenoma≥10 mm, or with high‐grade dysplasia or villous component) or adenocarcinoma. The clinical factors associated with ACRNs were determined for each age category (≤50 and >50 years), and the differences between the two categories were assessed. Odds ratios adjusted for age and sex were calculated.ResultsAmong 1001 patients (age≤50 years), ACRN was found in 94 (9.4%). In this younger category, male sex (adjusted odds ratio [aOR]:2.34, 95% confidence interval [CI]:1.51–3.63) and a family history of colorectal cancer (aOR:2.14, 95% CI:1.17–3.89) were significantly associated with higher odds of developing ACRNs. ACRNs were detected in 726 (15.9%) of 4579 patients (age >50 years). In the older age category, smoking (aOR:1.32, 95% CI:1.08–1.63) was significantly associated with a higher risk of ACRNs. Exercise of >3.5 metabolic equivalent of task (METs) (aOR,0.80; 95% CI:0.67–0.96) was significantly associated with a lower risk of ACRNs.ConclusionThe development of early‐onset ACRNs was primarily associated with congenital factors, whereas that of late‐onset ACRNs was associated with acquired ones. Colonoscopy is recommended for young male patients, particularly for those with a family history of colorectal cancer.
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