Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes.

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology and Hepatology Pub Date : 2024-11-24 DOI:10.1111/jgh.16833
Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
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Abstract

Background: Whether the progression of precursor lesions or the occurrence of cancer is influenced by lifestyle factors in carriers of genetic mutations has not been fully investigated, especially in Asian patients of hereditary colorectal cancer (CRC) syndrome.

Methods: Patients at a high risk of hereditary CRC were included. For polyposis CRC syndromes, colorectal polyp burden was measured using at least 60 images per colonoscopy in each patient and classified into five stages using the International Society for Gastrointestinal Hereditary Tumours staging system according to the polyp number and size. Increase in tumor burden stage for polyposis CRC syndrome and the occurrence of CRC or any cancer for Lynch syndrome were analyzed according to lifestyle factors.

Results: Ninety-six patients with suspected hereditary polyposis CRC syndrome and 106 patients with Lynch syndrome were recruited. For polyposis CRC syndromes, multivariate analysis showed that exposure to smoking and > 100 polyps independently predicted a high risk of increased polyp burden (p = 0.008 and p = 0.012, respectively). Significant genetic mutations or phenotype of polyposis syndromes were significantly associated with an increased polyp burden. For Lynch syndrome, smokers showed to be diagnosed with CRC in younger age than never-smokers (42.2 years vs. 49.0 years; p = 0.021), and heavy drinkers had high risk for occurrence of CRC (HR, 2.381, 95% CI, 1.338-4.236; p = 0.003) and any cancer (HR, 2.254; 95% CI, 1.334-3.806; p = 0.002).

Conclusions: The lifestyle factors (smoking and alcohol consumption) were associated with increasing precursor lesions and occurrence of cancer in patients with hereditary CRC syndrome. Lifestyle modifications may reduce the risk of hereditary CRC in carriers.

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生活方式对遗传性大肠癌综合征的息肉负担和癌症发展的影响
背景:遗传突变携带者的前驱病变进展或癌症发生是否受生活方式因素的影响尚未得到充分研究,尤其是在遗传性结直肠癌(CRC)综合征的亚洲患者中:方法:纳入遗传性 CRC 高风险患者。对于息肉病 CRC 综合征,每位患者每次结肠镜检查至少使用 60 张图像测量结肠直肠息肉负荷,并使用国际胃肠道遗传性肿瘤学会分期系统根据息肉数量和大小将其分为五个阶段。根据生活方式因素分析了息肉病 CRC 综合征肿瘤负荷分期的增加情况,以及林奇综合征 CRC 或任何癌症的发生情况:结果:共招募了 96 名疑似遗传性息肉病 CRC 综合征患者和 106 名林奇综合征患者。对于息肉病 CRC 综合征,多变量分析表明,吸烟和息肉大于 100 个可独立预测息肉负担增加的高风险(分别为 p = 0.008 和 p = 0.012)。息肉病综合征的重大基因突变或表型与息肉负荷增加有显著相关性。就林奇综合征而言,吸烟者确诊为 CRC 的年龄比从不吸烟者小(42.2 岁对 49.0 岁;p = 0.021),而酗酒者患 CRC(HR,2.381,95% CI,1.338-4.236;p = 0.003)和任何癌症(HR,2.254;95% CI,1.334-3.806;p = 0.002)的风险高:结论:生活方式因素(吸烟和饮酒)与遗传性 CRC 综合征患者前体病变的增加和癌症的发生有关。改变生活方式可降低遗传性 CRC 携带者的风险。
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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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