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首页> 外文期刊>Endoscopy International Open >Coexistent adenoma and serrated polyps on index colonoscopy and the risk of metachronous advanced colorectal neoplasia
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Coexistent adenoma and serrated polyps on index colonoscopy and the risk of metachronous advanced colorectal neoplasia

机译：在指数结肠镜检查的共存腺瘤和锯齿状息肉以及同学晚期结直肠瘤的风险

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Background and aims?The family of serrated polyps (SP) includes hyperplastic polyps (HP), sessile serrated adenomas/polyps, and traditional serrated adenoma. We investigated whether SP synchronous with adenoma at index colonoscopy is associated with metachronous advanced colorectal neoplasia (CRN). Methods?Patients with ≥?1 adenoma on index colonoscopy and who had undergone a follow-up colonoscopy were included. The patients were divided into four groups according to the presence of SP and advanced adenoma (AA) on index colonoscopy (non-AA, non-AA?+?SP, AA, AA?+?SP). The cumulative incidence of metachronous advanced CRN at surveillance colonoscopy was compared between groups. Results?Among a total of 2209 patients, the numbers of patients in the non-AA, non-AA?+?SP, AA, and AA?+?SP groups were 922, 441, 625, and 221, respectively. The cumulative incidence of metachronous advanced CRN was higher in patients in the AA?+?SP group than that in the AA group (PP?=?0.06). The cumulative incidence of metachronous advanced CRN at 3 years was 17.9?% [95?% confidence interval (CI) 8.0–27.6], 10.7?% [95?%CI 7.7–3.6], 3.5?% [95?%CI 1.3–5.6], and 3.4?% [95?%CI 2.0–4.7] in the AA?+?SP, AA, non-AA?+?SP, and non-AA group, respectively. In a multivariate analysis, overall SP [hazard ratio (HR) 2.24; 95?%CI 1.38–3.64, P?=?0.001], proximal SP (HR 2.31; 95?%CI 1.32–4.08), and HP (HR 2.19; 95?%CI 1.35–3.57) were risk factors for metachronous advanced CRN in patients with AA on index colonoscopy. Conclusions?Coexistent AA and SP on index colonoscopy significantly increased the risk of metachronous advanced CRN compared with AA alone. Further large prospective studies are needed to confirm whether more intensive follow-up improves outcomes in these high risk patients.
机译：背景和目标？锯齿状息肉（SP）的家族包括增生息肉（HP），无梗塞腺瘤/息肉和传统的锯齿状腺瘤。我们研究了在指数结肠镜检查中与腺瘤同步的SP同步是否与同赤结肠直肠瘤（CRN）相关。方法？≥1患者患者在指数结肠镜检查和经过后续结肠镜检查的情况下。根据IND指标结肠镜检查的SP和先进的腺瘤（AA）的存在，将患者分为四组（非AA，非AAα+α+ΔSP，AA，AA？+？SP）。在群体之间比较了在监测结肠镜检查时起肠癌高级CRN的累积发生率。结果？共2209名患者中，非AA的患者的数量，非AAα+β+β+ΔSP，AA和AA？SP组分别为922,441,625和221个。 AA + + + + + +α的患者中同学先进CRN的累积发生率高于AA组（PP？= 0.06）。 3年间同学的累积发病率为17.9？％[95〜27.6]，10.7？％[95〜27.6]，3.5〜％[95〜27.6]，3.5？％[95吗？％CI 1.3 -5.6]，和3.4？％[95〜95〜％CI 2.0-4.7]，分别在AA + + + +αsp，AA，非AAα+αSP和非AA组中。在多变量分析中，总SP [危险比（HR）2.24; 95？％CI 1.38-3.64，p？= 0.001]，近端SP（HR 2.31; 95〜95〜5.32-4.08）和HP（HR 2.19; 95？％CI 1.35-3.57）是同学先进的危险因素CRN患者AA在指数结肠镜检查中。结论？同期AA和SP在指数结肠镜检查中显着增加了与AA的AA相比同场先进CRN的风险。需要进一步的大型前瞻性研究来确认是否在这些高风险患者中提高了更多的密集随访。

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