Upper gastrointestinal tract polyps in familial adenomatosis coli.
Upper gastrointestinal tract polyps in familial adenomatosis coli.
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家族性大肠杆菌腺瘤病的上消化道息肉。
DOI：
10.1136/gut.24.4.333
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发表时间：
1983
期刊：
影响因子：
24.5
通讯作者：
P. Peltokallio
中科院分区：
文献类型：
--
作者：
H. Järvinen;M. Nyberg;P. Peltokallio
通过内窥镜检查和活组织检查，对属于 18 个不相关家族的 34 名患有家族性大肠杆菌的患者进行前瞻性寻找上消化道息肉。 28 名患者 (82%) 出现胃和/或十二指肠息肉，通常较小且多发。 19 名患者 (56%) 存在经组织学证实的结肠外腺瘤。胃腺瘤（均位于胃窦）和十二指肠腺瘤分别发生在 4 名（12%）和 16 名（48%）患者中。 1 名患者同时发现十二指肠腺癌和胆管腺瘤，1 名患者患有胆管腺癌。 19 名患者 (56%) 发现多发性非肿瘤性息肉，最常见于胃部，12 名患者也发现十二指肠；它们经常与腺瘤共存。此外，还有9名回肠息肉患者，其中大多数表现为淋巴组织增生，但也有1名患有腺瘤。有人认为，家族性腺瘤病影响整个胃肠道，而不仅仅是早期认为的结肠和直肠。尽管上消化道腺瘤不像结肠腺瘤那样一致和多发，并且可能不需要预防性手术，但由于癌症风险明显增加，因此有必要进行定期的终生内窥镜随访。
Upper gastrointestinal tract polyps were sought prospectively using endoscopy and biopsy in 34 patients with familial adenomatosis coli belonging to 18 unrelated families. Gastric and/or duodenal polyps, usually small and multiple, occurred in 28 patients (82%). Histologically verified extracolonic adenomas were present in 19 patients (56%). Gastric adenomas, all in the antrum, and duodenal adenomas occurred in four (12%) and 16 (48%) patients, respectively. In one patient, a duodenal adenocarcinoma and a bile duct adenoma were also found, and one patient had an adenocarcinoma of the bile ducts. Multiple non-neoplastic polyps were found in 19 patients (56%), most often in the stomach and also in the duodenum in 12 patients; they co-existed often with adenomas. In addition, there were nine patients with ileal polyps, most of them showing lymphoid hyperplasia but also one with adenomas. It is suggested that familial adenomatosis affects the whole gastrointestinal tract, not only the colon and rectum as believed earlier. Although upper gastrointestinal tract adenomas are not as consistent and multiple as those in the colon, and probably do not require prophylactic surgery, regular lifelong endoscopic follow up is warranted because of obviously increased cancer risk.