原创力文档a shift from distal to proximal neoplasia in the colon a decade of polyps and crc in italy转变从远到近端肿瘤结肠息肉和crc的十年意大利.pdfVIP
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a shift from distal to proximal neoplasia in the colon a decade of polyps and crc in italy转变从远到近端肿瘤结肠息肉和crc的十年意大利
Fenoglio et al. BMC Gastroenterology 2010, 10:139
/1471-230X/10/139
RESEARCH ARTICLE Open Access
A shift from distal to proximal neoplasia in the
colon: a decade of polyps and CRC in Italy
1* 1 2 1 3 1
Luigi Fenoglio , Elisabetta Castagna , Alberto Comino , Cora Luchino , Carlo Senore , Elena Migliore ,
1 1 1 4 1
Franco Capucci , Sergio Panzone , Alberto Silvestri , Luigi Ghezzo , Domenico Ferrigno
Abstract
Background: In the last years a trend towards proximalization of colorectal carcinomas (CRC) has been reported.
This study aims to evaluate the distribution of CRC and adenomatous polyps (ADP) to establish the presence of
proximalization and to assess the potential predictors.
Methods: We retrieved histology reports of colonic specimens excised during colonoscopy, considering the exams
performed between 1997 and 2006 at Cuneo Hospital, Italy. We compared the proportion of proximal lesions in
the period 1997-2001 and in the period 2002-2006.
Results: Neoplastic lesions were detected in 3087 people. Proximal CRC moved from 25.9% (1997-2001) to 30.0%
(2002-2006). Adjusting for sex and age, the difference was not significant (OR 1.23; 95% CI: 0,95-1,58). The proximal
ADP proportion increased from 19.2% (1997-2001) to 26.0% (2002-2006) (OR: 1.43; 95% CI: 1.17-1.89). The
corresponding figures for advanced proximal ADP were 6.6% and 9.5% (OR: 1.48; 95% CI: 1.02-2.17). Adjusting for
gender, age, diagnostic period, symptoms and number of polyps the prevalence of proximal advanced ADP was
increased among people ≥ 70 years compared to those aged 55-69 years (OR 1.49; 95% CI: 1.032.16). The main
predictor of pro
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