據(jù)3月5日《美國醫(yī)學(xué)協(xié)會(huì)期刊》（JAMA）上的一則研究顯示,，扁平非息肉樣結(jié)腸直腸新生物（NP-CRNs）可能難以發(fā)現(xiàn)，但它們看來還是比較常見,，且其與更為常規(guī)診斷的結(jié)腸直腸息肉性病變相比與癌癥的關(guān)系更大。
結(jié)腸直腸癌是美國癌癥死亡中排名第二的原因,。對此病的預(yù)防聚焦在對息肉樣（外觀類似息肉）新生物（一種新的異常生長物）的發(fā)現(xiàn)與移除上,。但是，最近的研究證明了結(jié)腸直腸癌也可能來自NP-CRNs,。
美國加州Veterans Affairs Palo Alto衛(wèi)生保健系統(tǒng)的Roy M. Soetikno及其同僚對一組經(jīng)歷了選擇性結(jié)腸鏡檢查的1819位病人的數(shù)據(jù)進(jìn)行了檢驗(yàn),，以估測NP-CRNs的發(fā)病率,，并對NP-CRNs與結(jié)場直腸癌的相關(guān)性進(jìn)行了調(diào)查。
作者在文章中寫道：“我們的結(jié)論是,，在某單一的Veterans Affairs醫(yī)院的病患人群中,，NP-CRNs在結(jié)腸鏡檢查時(shí)相對較為常見。它們比息肉樣新生物更可能含有癌性病變,，而這種特性與病變的大小無關(guān),。最近的研究已經(jīng)發(fā)現(xiàn)了非息肉樣與息肉性結(jié)腸直腸腫瘤間的基礎(chǔ)遺傳機(jī)制方面的差別。未來對NP-CRNs的研究應(yīng)該進(jìn)一步評估診斷去除NP-CRNs對結(jié)腸直腸癌的預(yù)防及死亡率是否有任何的作用,，并特別關(guān)注其在遺傳及蛋白質(zhì)方面的異常性,。”（來源：EurekAlert!中文版）
生物谷推薦原始出處：
（JAMA），2008;299(9):1027-1035,，Roy M. Soetikno,，Shai Friedland
Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults
Roy M. Soetikno, MD, MS; Tonya Kaltenbach, MD, MS; Robert V. Rouse, MD; Walter Park, MD; Anamika Maheshwari, MD; Tohru Sato, MD; Suzanne Matsui, MD; Shai Friedland, MD, MS
JAMA. 2008;299(9):1027-1035.
Context Colorectal cancer is the second leading cause of cancer death in the United States. Prevention has focused on the detection and removal of polypoid neoplasms. Data are limited on the significance of nonpolypoid colorectal neoplasms (NP-CRNs).
Objectives To determine the prevalence of NP-CRNs in a veterans hospital population and to characterize their association with colorectal cancer.
Design, Setting, and Patients Cross-sectional study at a veterans hospital in California with 1819 patients undergoing elective colonoscopy from July 2003 to June 2004.
Main Outcome Measures Endoscopic appearance, location, size, histology, and depth of invasion of neoplasms.
Results The overall prevalence of NP-CRNs was 9.35% (95% confidence interval [95% CI], 8.05%-10.78%; n = 170). The prevalence of NP-CRNs in the subpopulations for screening, surveillance, and symptoms was 5.84% (95% CI, 4.13%-8.00%; n = 36), 15.44% (95% CI, 12.76%-18.44%; n = 101), and 6.01% (95% CI, 4.17%-8.34%; n = 33), respectively. The overall prevalence of NP-CRNs with in situ or submucosal invasive carcinoma was 0.82% (95% CI, 0.46%-1.36%; n = 15); in the screening population, the prevalence was 0.32% (95% CI, 0.04%-1.17%; n = 2). Overall, NP-CRNs were more likely to contain carcinoma (odds ratio, 9.78; 95% CI, 3.93-24.4) than polypoid lesions, irrespective of the size. The positive size-adjusted association of NP-CRNs with in situ or submucosal invasive carcinoma was also observed in subpopulations for screening (odds ratio, 2.01; 95% CI, 0.27-15.3) and surveillance (odds ratio, 63.7; 95% CI, 9.41-431). The depressed type had the highest risk (33%). Nonpolypoid colorectal neoplasms containing carcinoma were smaller in diameter as compared with the polypoid ones (mean [SD] diameter, 15.9 [10.2] mm vs 19.2 [9.6] mm, respectively). The procedure times did not change appreciably as compared with historical controls.
Conclusion In this group of veteran patients, NP-CRNs were relatively common lesions diagnosed during routine colonoscopy and had a greater association with carcinoma compared with polypoid neoplasms, irrespective of size.
