臨床上結腸鏡檢查手術過程中,，一根前頭裝備攝像頭的軟管順著患者口腔食管一直插入直腸中，然后將軟管滑行延伸至患者結腸部位,。在進行結腸鏡檢查時,，尚未發(fā)生癌變的腺瘤性息肉是結腸部位最常見的異樣物質。如果在做結腸鏡檢查手術時不及時將它切除的話,，腺瘤性息肉有很有可能發(fā)生癌變,，導致結腸癌的發(fā)生。
美國癌癥研究院統(tǒng)計顯示：2011年,，美國有100,000對例新增結腸癌病例,，40,000多例新增直腸癌病例，有49,000名結腸/直腸癌患者死亡,。來自美國Memorial Sloan-Kettering癌癥中心的研究人員早些時候完成的一項研究證實在進行結腸鏡檢查的時候，切除癌前期息肉能起到預防結腸癌發(fā)展的作用,。2月23日,，N Engl J Med上刊出的一篇研究論文指出：在結腸鏡檢查時切除癌前期息肉能使患者因結腸癌死亡的風險減半。該研究也是由美國Memorial Sloan-Kettering癌癥中心領導,，研究人員包括內視鏡專家,、病理學家、放射學家和流行病學家等,。
該項研究的主要領導者Memorial Sloan-Kettering癌癥中心的生物統(tǒng)計學家--Ann G. Zauber博士稱：這項研究證實了我們能從切除結腸部位腺瘤性息肉手術中長期受益,，我們完全可以利用結腸鏡檢查手術篩查50歲以上的群體是否罹患結腸癌。
Zauber等人調查研究了NPS數據庫中患者病例信息,，NPS（美國息肉研究）收錄了1980至1990年間,，美國各地患者接受結腸鏡檢查的相關信息。工作者收集了2,602名在結腸鏡檢查手術中切除腺瘤性息肉的患者信息,，并進行隨訪,，其中最長的追訪研究長達23年,。結果發(fā)現在15.8年（中位數）以后，有1,246名患者因為罹患其他疾病病去世,，因罹患結腸癌去世的人數只有12名,。
研究人員還發(fā)現不管癌癥患者之前長得是不是已經癌變或是未發(fā)生癌變的腺瘤性息肉，在接受結腸鏡檢查時切除息肉后的頭十年里,，結腸癌患者死亡率都很低,。
該研究另一主要領導者--消化系統(tǒng)癌癥專家Winawer教授認為結腸鏡檢查術應該作為美國結腸癌篩查指南中的關鍵部分，要在全球范圍內進行推廣,。（生物谷Bioon.com）
doi:10.1056/NEJMoa1100370
PMC:
PMID:
Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths
Ann G. Zauber, Ph.D., Sidney J. Winawer, M.D., Michael J. O'Brien, M.D., M.P.H., Iris Lansdorp-Vogelaar, Ph.D., Marjolein van Ballegooijen, M.D., Ph.D.,et al.
Background
In the National Polyp Study (NPS), colorectal cancer was prevented by colonoscopic removal of adenomatous polyps. We evaluated the long-term effect of colonoscopic polypectomy in a study on mortality from colorectal cancer.
Methods
We included in this analysis all patients prospectively referred for initial colonoscopy (between 1980 and 1990) at NPS clinical centers who had polyps (adenomas and nonadenomas). The National Death Index was used to identify deaths and to determine the cause of death; follow-up time was as long as 23 years. Mortality from colorectal cancer among patients with adenomas removed was compared with the expected incidence-based mortality from colorectal cancer in the general population, as estimated from the Surveillance Epidemiology and End Results (SEER) Program, and with the observed mortality from colorectal cancer among patients with nonadenomatous polyps (internal control group).
Results
Among 2602 patients who had adenomas removed during participation in the study, after a median of 15.8 years, 1246 patients had died from any cause and 12 had died from colorectal cancer. Given an estimated 25.4 expected deaths from colorectal cancer in the general population, the standardized incidence-based mortality ratio was 0.47 (95% confidence interval [CI], 0.26 to 0.80) with colonoscopic polypectomy, suggesting a 53% reduction in mortality. Mortality from colorectal cancer was similar among patients with adenomas and those with nonadenomatous polyps during the first 10 years after polypectomy (relative risk, 1.2; 95% CI, 0.1 to 10.6).
Conclusions
These findings support the hypothesis that colonoscopic removal of adenomatous polyps prevents death from colorectal cancer. (Funded by the National Cancer Institute and others.)
