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中华胃肠内镜电子杂志 ›› 2024, Vol. 11 ›› Issue (01) : 18 -22. doi: 10.3877/cma.j.issn.2095-7157.2024.01.005

论著

大肠黑变病与侧向生长型肿瘤的临床研究
温栋惠1, 张克1, 张昊1, 马连君1, 张斌1,()   
  1. 1. 130033 长春,吉林大学中日联谊医院胃肠内科(内镜中心)
  • 收稿日期:2024-01-16 出版日期:2024-02-15
  • 通信作者: 张斌
  • 基金资助:
    吉林省发改委资助项目(3J1196575429)

Clinical study on melanosis coli and laterally spreading tumors

Donghui Wen1, Ke Zhang1, Hao Zhang1, Lianjun Ma1, Bin Zhang1,()   

  1. 1. Department of Gastroenterology(Endoscopy Center), China-Japan Union Hospital of Jilin University, Changchun 130033, China
  • Received:2024-01-16 Published:2024-02-15
  • Corresponding author: Bin Zhang
引用本文:

温栋惠, 张克, 张昊, 马连君, 张斌. 大肠黑变病与侧向生长型肿瘤的临床研究[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(01): 18-22.

Donghui Wen, Ke Zhang, Hao Zhang, Lianjun Ma, Bin Zhang. Clinical study on melanosis coli and laterally spreading tumors[J/OL]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(01): 18-22.

目的

探讨大肠黑变病(MC)与侧向生长型肿瘤(LST)是否有关联,以及MC的癌变风险。

方法

回顾性研究我院2018年至2022年结肠镜诊断为MC的患者,使用倾向匹配得分(PSM),将年龄、性别作为匹配变量,进行MC组和对照组的1∶2最邻近匹配,最终共入组361例MC与722例对照,分析LST与MC的关系。

结果

MC组与对照组的LST检出率分别为10.7%和6.2%(P=0.040),进一步行二元Logistic回归分析显示,MC与LST检出率增加显著相关(OR:1.487,95%CI: 1.096~2.012,P=0.010)。此外,MC中的LST恶变率增高(P=0.026),二元Logistic回归分析证明MC为LST恶变的危险因素(OR:1.825,95%CI: 1.276~2.611,P=0.001)。LST的检出与MC的分布(P=0.005)、级别(P=0.045)相关。

结论

MC中LST检出率增高,且LST恶性肿瘤发生率增高。

Objective

To explore whether melanosis coli (MC) and is associated with laterally spreading tumors (LST), and the cancer risk.

Methods

We conducted a retrospective study involving patients diagnosed with melanosis coli through colonoscopy at our hospital between 2018 and 2022, and propensity matching scores (PSM) were performed. Age and gender were used as matching variables to perform 1∶2 nearest-neighbor matching between the MC group and the control group. A total of 361 MC patients and 722 controls were enrolled in the study, and our analysis sought to examine the relationship between LST and MC.

Results

The LST detection rates in the MC and control groups were 10.7% and 6.2%, respectively (P=0.040), and further binary logistic regression analysis showed that MC was significantly correlated with an increased LST detection rate (OR: 1.487, 95%CI: 1.096-2.012, P=0.010). In addition, the rate of LST malignancy was increased in MC (P=0.026), and binary logistic regression analysis demonstrated that MC was a risk factor for LST malignancy (OR: 1.825, 95%CI: 1.276-2.611, P=0.001). LST detection was correlated with the distribution (P=0.005), and grade (P=0.045) of MC.

Conclusion

The detection rate of LST is higher in MC compared to the control group, and the incidence of LST malignancy is higher in MC.

图1 MC中的LST注:A:MC Ⅰ级;B:MC Ⅱ级;C: MC Ⅲ级
表1 患者和对照组的基线特征的对比[例(%)]
表2 LST检出相关因素的二元Logistic回归分析
表3 MC中的LST的特征[例(%)]
表4 LST恶变相关因素的二元Logistic回归分析
表5 有无检出LST的MC的对比[例(%)]
[1]
虎金朋,杨珍,牛敏,等. 620例结肠黑变病临床资料分析[J/CD]. 中华胃肠内镜电子杂志2019, 6(2): 66-69.
[2]
Yang NRuan MJin S.Melanosis coli:A comprehensive review[J]. Gastroenterol Hepatol, 2020, 43(5): 266-272.
[3]
Zhang YZhan TTDong ZY,et al. Melanosis coli:A factor not associated with histological progression of colorectal polyps[J].J Dig Dis2022, 23(5-6): 302-309.
[4]
Blackett JWRosenberg RMahadev S,et al.Adenoma Detection is Increased in the Setting of Melanosis Coli[J]. J Clin Gastroenterol, 2018, 52(4): 313-318.
[5]
Nusko GSchneider BErnst H,et al.Melanosis coli-a harmless pigmentation or a precancerous condition?[J].Z Gastroenterol1997, 35(5): 313-318.
[6]
Kassim SAAbbas MTang W,et al.Retrospective study on melanosis coli as risk factor of colorectal neoplasm: a 3-year colonoscopic finding in Zhuhai Hospital, China[J]. Int J Colorectal Dis, 2020, 35(2): 213-222.
[7]
Kaku EOda YMurakami Y, et al. Proportion of flat- and depressed-type and laterally spreading tumor among advanced colorectal neoplasia[J]. Clin Gastroenterol Hepatol, 2011, 9(6): 503-508.
[8]
Hong JYKweon SSLee J,et al.Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors[J]. Medicine (Baltimore), 2018, 97(41): e12589.
[9]
施海韵,许瑶,曹飞,等.结直肠侧向发育型肿瘤癌变的内镜学特征[J]. 中华消化内镜杂志2020, 37(6): 404-408.
[10]
Liu ZHFoo DCCLaw WL,et al.Melanosis coli: Harmless pigmentation? A case-control retrospective study of 657 cases[J].PLoS One2017, 12(10): e0186668.
[11]
李增山,李青. 2010年版消化系统肿瘤WHO分类解读[J]. 中华病理学杂志201140 (5): 351-354.
[12]
Katsumata RManabe NFujita M,et al.Colorectal neoplasms in melanosis coli:a survey in Japan and a worldwide meta-analysis[J].Int J Colorectal Dis202136(10): 2177-2188.
[13]
Van Gorkom BAKarrenbeld AVan Der Sluis T,et al.Influence of a highly purified senna extract on colonic epithelium[J].Digestion2000, 61(2): 113-120.
[14]
Yuan SWang PZhou X, et al.Differential proteomics mass spectrometry of melanosis coli[J].Am J Transl Res202012(7): 3133-3148.
[15]
Kudo S.About laterally spreading tumor[J].Early Colorectal Cancer, 19982(5): 477-481.
[16]
李继昂,冯洁,黄晓俊.结直肠侧向发育型肿瘤内镜下治疗的研究进展[J].中华消化内镜杂志2023, 39(7): 566-570.
[17]
Li DHLiu XYHuang C, et al.Pathological Analysis and Endoscopic Characteristics of Colorectal Laterally Spreading Tumors[J].Cancer Manag Res, 2021, 13(9): 1137-1144.
[18]
Kudo SETakemura OOhtsuka K.Flat and depressed types of early colorectal cancers: from East to West[J]. Gastrointest Endosc Clin N Am, 200818(3): 581-593, xi.
[19]
Urban OVitek PFojtik P,et al.Laterally spreading tumors-experience based on 138 consecutive cases[J].Hepatogastroenterology2008, 55(82-83): 351-355.
[20]
赵天翔,张凤娟,孙明军.结直肠侧向发育型肿瘤的内镜特征及癌变与黏膜下浸润的危险因素分析[J].中华消化内镜杂志2023, 39(8): 639-647.
[21]
Kiriyama SSaito YYamamoto S,et al.Comparison of endoscopic submucosal dissection with laparoscopic-assisted colorectal surgery for early-stage colorectal cancer:a retrospective analysis[J].Endoscopy, 2012, 44(11): 1024-1030.
[22]
Ahlenstiel GHourigan LFBrown G,et al.Actual endoscopic versus predicted surgical mortality for treatment of advanced mucosal neoplasia of the colon[J].Gastrointest Endosc, 2014, 80(4): 668-676.
[23]
张展鹏,郝钰洁,严艳. 结直肠侧向发育型肿瘤并发结直肠息肉的预测因子及发生恶变的危险因素[J].中华消化内镜杂志2023, 39(7): 527-533.
[24]
Castillo-Regalado EUchima H. Endoscopic management of difficult laterally spreading tumors in colorectum[J]. World J Gastrointest Endosc, 2022, 14(3): 113-128.
[25]
Doll RHostoffer R.Disappearance of Melanosis Coli After Administration of IVIG[J]. Am J Gastroenterol, 2017, 112(3): 517-518.
[26]
Harris ABuchanan GN. Melanosis coli is reversible[J]. Colorectal Dis, 2009, 11(7): 788-789.
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