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GUT:锯齿状息肉综合征的个性化监测方案研究

2019-04-15 MedSci MedSci原创

研究认为, III型锯齿状息肉病综合征患者结肠癌风险低于其他亚型,上述患者可考虑延长结肠镜监测间隔

锯齿状息肉病综合征(SPS)与直肠癌(CRC)风险增加有关。现行指南建议每隔1到2年进行一次结肠镜检查,但每年的监测可能会导致患者过度治疗,近日研究人员评估了减少结肠镜检查负担监测方案的效果。

2013-2018年间, 9家荷兰和西班牙医院的SPS患者参与研究。根据息肉负担,在每一次结肠镜检查后,接受1年或2年的间隔检查方案。研究的主要终点是5年中间隔期CRC和晚期肿瘤(AN)的累积发病率。

研究人员对271名SPS患者进行了平均3.6年的随访。在监测期间,有2名患者发展成为CRC(累计5年发病率1.3%)。5年AN发病率为44%, SPS Ⅲ型患者AN累积率低于I型及I-III混合型患者(26% vs53% vs59%,P<0.001)。大多数患者推荐的监测间隔为2年,且不增加2年间隔患者的AN风险(2年间隔 vs 1年间隔,15.6% vs 24.4%,OR=0.57)。

研究认为, III型锯齿状息肉病综合征患者结肠癌风险低于其他亚型,上述患者可考虑延长结肠镜监测间隔。

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