Clinical impact of colonoscopy for patients with early gastric cancer treated by endoscopic submucosal dissection: A matched case-control study

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• 作者：Kenichiro Imai^a ; ^{k.imai1977@gmail.com} ; Kinichi Hotta^a ; Yuichiro Yamaguchi^a ; Noboru Kawata^a ; Naomi Kakushima^a ; Masaki Tanaka^a ; Kohei Takizawa^a ; Hiroyuki Matsubayashi^a ; Tadakazu Shimoda^b ; Keita Mori^c ; Hiroyuki Ono^a
• 关键词：Colonoscopy ; Colon cancer ; Endoscopic submucosal dissection ; Gastric cancer ; Helicobacter pylori
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：49
• 期：2
• 页码：207-212
• 全文大小：659 K
• 卷排序：49

文摘

Gastric cancer frequently occurs synchronously with colorectal cancer (CRC).AimsThe aim of the present study was to assess the value of colonoscopy in patients with primariy early gastric cancer (EGC) indicated for endoscopic submucosal dissection (ESD) and to identify predictors for the risk of high-risk adenomas.MethodsA total of 130 patients with EGC, who underwent both colonoscopy and gastric ESD, and 260 controls matched for age and sex, who underwent a colonoscopy as part of our institutional health check-up program.The prevalence of high-risk adenomas in EGC patients vs. controls was evaluated.ResultsHigh-risk adenomas were found in 43 (33%) EGC patients and 37 (14%) controls (P < 0.01). Multivariate analysis showed the presence of EGC was significantly associated with high-risk adenoma [odds ratio (OR) 2.8, 95% confidence interval (CI): 1.7–4.9]. Among EGC patients, high serum CEA level (OR 2.4, 95% CI: 1.2–5.0) was an independent predictor for high-risk adenoma.ConclusionsPatients with EGC had a significant risk for colorectal cancer. When endoscopists detected an early gastric cancer indicated for ESD, colonoscopy should be considered for EGC patients with high serum CEA levels.