Risk factors for colorectal cancer in patients with multiple serrated polyps: a cross-sectional case series from genetics clinics.
Risk factors for colorectal cancer in patients with multiple serrated polyps: a cross-sectional case series from genetics clinics.
复制标题
DOI：
10.1371/journal.pone.0011636
复制
发表时间：
2010-07-16
期刊：
影响因子：
3.7
通讯作者：
Young JP
中科院分区：
文献类型：
--
作者：
Buchanan DD;Sweet K;Drini M;Jenkins MA;Win AK;English DR;Walsh MD;Clendenning M;McKeone DM;Walters RJ;Roberts A;Pearson SA;Pavluk E;Hopper JL;Gattas MR;Goldblatt J;George J;Suthers GK;Phillips KD;Woodall S;Arnold J;Tucker K;Muir A;Field M;Greening S;Gallinger S;Perrier R;Baron JA;Potter JD;Haile R;Frankel W;de la Chapelle A;Macrae F;Rosty C;Walker NI;Parry S;Young JP
多发性锯齿状息肉患者患结直肠癌（CRC）的风险增加。最近的报道将吸烟与从锯齿状息肉发展而来的CRC子集联系起来。因此，这项工作的目的是调查吸烟与多发性锯齿状息肉的高危遗传学临床患者CRC风险之间的关系。我们确定了151名患有多发性锯齿状息肉的高加索人，其中至少有5个在直肠外，并在初步诊断息肉病时将患者分为不吸烟者、当前吸烟者或既往吸烟者。病例是患有多个锯齿状息肉的个体，他们表现为CRC。对照组为患有多发性锯齿状息肉且无CRC的个体。进行多变量logistic回归以估计吸烟与CRC之间的关联，并调整首次就诊时的年龄、性别和共存的传统腺瘤，这一特征一直与多发性锯齿状息肉患者的CRC风险相关。CRC存在于56（37%）个人在介绍。至少有一个腺瘤的患者出现CRC的可能性是无腺瘤患者的4倍（OR = 4.09; 95%CI 1.27 - 13.14; P = 0.02）。 对于女性，在调整年龄和腺瘤后，与从不吸烟者相比，目前吸烟者的CRC几率降低了90%（OR = 0.10; 95%CI 0.02至0.47; P = 0.004）。 对于男性，目前吸烟与CRC之间没有关系。没有统计学证据表明男女既往吸烟与CRC之间存在关联。患有多发性锯齿状息肉且目前吸烟的女性患CRC的几率降低，与年龄和传统腺瘤的存在无关。对这些观察结果的生物学基础的调查可能会导致正在开发的非吸烟相关疗法，以降低这些患者的CRC和结肠切除术的风险。
Patients with multiple serrated polyps are at an increased risk for developing colorectal cancer (CRC). Recent reports have linked cigarette smoking with the subset of CRC that develops from serrated polyps. The aim of this work therefore was to investigate the association between smoking and the risk of CRC in high-risk genetics clinic patients presenting with multiple serrated polyps. We identified 151 Caucasian individuals with multiple serrated polyps including at least 5 outside the rectum, and classified patients into non-smokers, current or former smokers at the time of initial diagnosis of polyposis. Cases were individuals with multiple serrated polyps who presented with CRC. Controls were individuals with multiple serrated polyps and no CRC. Multivariate logistic regression was performed to estimate associations between smoking and CRC with adjustment for age at first presentation, sex and co-existing traditional adenomas, a feature that has been consistently linked with CRC risk in patients with multiple serrated polyps. CRC was present in 56 (37%) individuals at presentation. Patients with at least one adenoma were 4 times more likely to present with CRC compared with patients without adenomas (OR = 4.09; 95%CI 1.27 to 13.14; P = 0.02). For females, the odds of CRC decreased by 90% in current smokers as compared to never smokers (OR = 0.10; 95%CI 0.02 to 0.47; P = 0.004) after adjusting for age and adenomas. For males, there was no relationship between current smoking and CRC. There was no statistical evidence of an association between former smoking and CRC for both sexes. A decreased odds for CRC was identified in females with multiple serrated polyps who currently smoke, independent of age and the presence of a traditional adenoma. Investigations into the biological basis for these observations could lead to non-smoking-related therapies being developed to decrease the risk of CRC and colectomy in these patients.
登录
查看更多内容
影响因子：
9.8
作者：
Anderson, JC;Attam, R;Brand, DL
通讯作者：
Brand, DL
影响因子：
6.2
作者：
Colangelo, LA;Gapstur, SM;Dyer, AR
通讯作者：
Dyer, AR
影响因子：
29.4
作者：
Chow, Elizabeth;Lipton, Lara;Macrae, Finlay
通讯作者：
Macrae, Finlay
影响因子：
9.8
作者：
Lage, P;Cravo, M;Nobre-Leitao, C
通讯作者：
Nobre-Leitao, C
影响因子：
3.9
作者：
Buc, Emmanuel;Kwiatkowski, Fabrice;Slim, Karem
通讯作者：
Slim, Karem