Fossi S, Bazzoli F, Ricciardiello L, Nicolini G, Zagari R M, Pozzato P, Palli D, Roda E
Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Italy.
Am J Gastroenterol. 2001 May;96(5):1601-4. doi: 10.1111/j.1572-0241.2001.03784.x.
Subjects with one first-degree relative affected with colorectal cancer are considered to be at increased risk of colorectal adenomas. We compared the recurrence and incidence rates of colorectal adenomas among subjects with one first-degree relative with colorectal cancer and those without family history.
A series of consecutive asymptomatic subjects successfully underwent a colonoscopy, were found to have either normal results or at least one adenoma, provided a detailed family history, and were offered a second colonoscopy 3 yr later; 190 out of 436 subjects accepted, 134/172 with one or more adenomas and 56/264 with no abnormalities at the initial examination. A first-degree family history was reported by 43/134 and 26/56, respectively.
By multivariate analysis, the presence of adenomas at follow-up examination was significantly associated with a positive family history of colorectal cancer in both subgroups, those with a previously resected adenoma (odds ratio = 2.23, 95% CI = 1.04-4.79) and those without (odds ratio = 8.95, CI = 1.29-62.22).
A history of one first-degree relative with colorectal cancer is associated with a significant increase in 3-yr cumulative incidence and recurrence rates of adenomas.
有一位患结直肠癌的一级亲属的受试者被认为患结直肠腺瘤的风险增加。我们比较了有一位患结直肠癌的一级亲属的受试者与无家族病史的受试者中结直肠腺瘤的复发率和发病率。
一系列连续的无症状受试者成功接受了结肠镜检查,结果显示正常或至少有一个腺瘤,提供了详细的家族病史,并在3年后接受了第二次结肠镜检查;436名受试者中有190名接受了检查,其中134/172名在初次检查时有一个或多个腺瘤,56/264名无异常。分别有43/134和26/56报告有一级家族病史。
通过多变量分析,在两个亚组中,随访检查时腺瘤的存在与结直肠癌的阳性家族病史显著相关,这两个亚组分别是先前切除过腺瘤的(比值比=2.23,95%可信区间=1.04-4.79)和未切除过腺瘤的(比值比=8.95,可信区间=1.29-62.22)。
有一位患结直肠癌的一级亲属的病史与腺瘤3年累积发病率和复发率的显著增加相关。