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首页> 外文期刊>Endoscopy: Journal for Clinical Use Biopsy and Technique >Preventing colorectal cancer and cancer mortality with colonoscopy: what we know and what we don't know.
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Preventing colorectal cancer and cancer mortality with colonoscopy: what we know and what we don't know.

机译：通过结肠镜检查预防大肠癌和癌症死亡率：我们知道和不知道的。

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摘要

The goal of most colonoscopies is the prevention of incident colorectal cancer and especially death from colorectal cancer. The effectiveness of colo-noscopy is now justly under attack following the publication of studies showing that colonoscopy reduces the risk of distal colorectal cancer and advanced neoplasms but has no [1,2] or limited [3] effect on the incidence of proximal neoplasms. The reasons for no or limited proximal colon protection by colonoscopy are uncertain, but there are two broad categories of possible explanations. One category is altered biology in the proximal colon. Interval cancers in the proximal colon are more likely to be microsatellite unstable (MSI) and to bear the CpG Island Me-thylator Phenotype (CIMP) [4]. MSI is known to push tumors through the adenoma-carcinoma sequence rapidly, and CIMP tumors are believed to be the end product of serrated polyps, a group of lesions that are endoscopically subtle and about which little is known compared with adenomas.
机译：大多数结肠镜检查的目的是预防大肠癌的发生，尤其是大肠癌的死亡。研究表明结肠镜检查降低了远端结直肠癌和晚期肿瘤的风险，但对近端肿瘤的发生没有[1,2]或有限的[3]影响，因此，结肠镜检查的有效性正受到攻击。结肠镜检查对近端结肠的保护没有或受到限制的原因尚不确定，但可能的解释有两大类。一类是近端结肠的生物学改变。在近端结肠的间隔癌更有可能是微卫星不稳定（MSI）并带有CpG岛型甲基甲状腺素表型（CIMP）[4]。已知MSI可以迅速将肿瘤穿过腺瘤-癌序列，而CIMP肿瘤被认为是锯齿状息肉的终产物，锯齿状息肉是一组内窥镜微妙的病变，与腺瘤相比鲜为人知。

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