Περίληψη:
OBJECTIVE The few published prospective studies suggest a strong
association of colonic tumours with acromegaly, but include small
numbers of patients. In addition, the upper gastrointestinal tract of
these patients has never been prospectively studied. The aim of the
present study was to investigate the incidence of gastric and colonic
tumours in a large cohort of acromegalic patients.
DESIGN Acromegalic patients consecutively admitted to an Endocrinology
Department for diagnosis and followup, were submitted to gastroscopy and
colonoscopy, to identify those harbouring gastrointestinal tumours.
PATIENTS Over a 5-year period, 54 out of 61 patients (78% with active
disease) received colonoscopy and 42 out of 61 gastroscopy. No patient
had a past history of gastrointestinal malignancy.
MEASUREMENTS All polypoid lesions found at colonoscopy and gastroscopy
were separately recorded and biopsied.
RESULTS No case of gastrointestinal cancer or gastric polyp was
discovered. Nineteen patients (35%) had 1-8 colonic polyps, including 5
(9.3%) with adenomas. When compared to patients with a normal colon,
those with polyps were significantly older (44.5 +/- 14.2 vs 52.1 +/-
10.9 years, P = 0.047), but the duration of acromegaly (10.8 +/- 8.4 vs
10.9 +/- 7.1 years, P = 0.9) and the number of patients with active
disease were similar in both groups.
CONCLUSIONS Acromegalic patients do not have an increased incidence of
gastric tumours. The observed significant variation in the prevalence of
colonic adenomas (9-35%, P = 0.03) and cancer (0-15%, P = 0.017),
between our patients and those of the published prospective studies with
similar demographic characteristics, suggest that environmental and
hereditary factors may be more important than the presence of
acromegaly.
Συγγραφείς:
LADAS, SD
THALASSINOS, NC
IOANNIDES, G
RAPTIS, SA
