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Riesgo aumentado de lesiones colónicas preneoplásicas en acromegalia: estudio multicéntrico caso control. Resultados preliminares

Published on Oct 1, 2017in Revista Argentina de Endocrinología y Metabolismo
· DOI :10.1016/j.raem.2017.07.006
María Florencia Battistone , Monica Graciela Loto5
Estimated H-index: 5
+ 24 AuthorsMirtha Guitelman9
Estimated H-index: 9
Abstract
Resumen Introduccion El riesgo de desarrollar neoplasias colonicas en pacientes acromegalicos y su relacion directa con los niveles elevados de GH/IGF-1 no estan bien establecidos y continuan siendo motivo de controversia en la literatura mundial. El objetivo de este trabajo fue evaluar el riesgo de desarrollar lesiones neoplasicas avanzadas (LNA) (adenomas mayores a 1 cm, componente velloso mayor del 75% y/o displasia de alto grado), en pacientes con acromegalia, comparado con un grupo control. Materiales y metodos Estudio multicentrico caso-control retrospectivo. Ciento treinta y siete pacientes con acromegalia que realizaron videocolonoscopia (VCC) fueron incluidos inicialmente, aunque solo 69 cumplieron criterios de inclusion. Sesenta y dos controles fueron obtenidos: por cada caso (paciente con acromegalia) 2 «controles» fueron seleccionados aleatorizadamente e igualados por edad y sexo. El riesgo se expreso en odds ratio (OR) y su correspondiente intervalo de confianza (IC) del 95%. La significacion estadistica fue considerada una p  Resultados De los 69 pacientes con VCC completa y datos adecuados para su analisis, 28 presentaron VCC positiva con hallazgos de polipos (40%) y 41 VCC negativa o normal (60%). Dentro del grupo con VCC positiva, 14 presentaron LNA (20%) y solo un paciente presento diagnostico de cancer colorrectal. Para el analisis caso-control se incluyo a 31 pacientes frente al grupo control (n = 62) que cumplieron con los criterios de inclusion. La presencia de polipos colonicos, adenomas y LNA en los pacientes con acromegalia fue de 19/31 (61,9%), 14/31 (45,16%) y 10/31 (32,25%), y en el grupo control de 18/62 (29,03%), 11/62 (17,74%) y 4/62 (6,45%), respectivamente. El riesgo de adenomas y LNA fue mayor en el grupo de acromegalia en comparacion con el grupo control, siendo ambos resultados estadisticamente significativos: adenomas OR 2,54 (IC 1,22-5,25) p = 0,005, LNA OR: 7,3 (2,4-25), p = 0,00. Conclusion La acromegalia se asocia a un mayor riesgo de lesiones colonicas preneoplasicas. Este hallazgo justifica el cribado con VCC al diagnostico en pacientes con acromegalia.
  • References (37)
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References37
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#1Tanya BurtonH-Index: 2
Last. William H. Ludlam (Novartis)H-Index: 5
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Purpose Incidence and prevalence estimates of acromegaly in the United States (US) are limited. Most existing reports are based on European data sources. The objective of this study was to estimate the annual incidence and prevalence of acromegaly in a large US managed care population, overall and stratified by age, sex, and geographic region, using data from 2008 to 2012.
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#1David PetroffH-Index: 18
#2Anke Tönjes (Leipzig University)H-Index: 56
Last. Christof SchöflH-Index: 25
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Context: Acromegaly is a rare disease characterized by high serum levels of GH and IGF-1. Animal studies have demonstrated links between these hormones and cancer, but data regarding cancer incidence among acromegaly patients are inconsistent. Moreover, therapy options have changed considerably since many of the aforementioned data were collected. Objective: The objective was to determine whether the overall and site-specific incidence of cancer is comparable to that of the general population. D...
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Last. R. A. James (Newcastle upon Tyne Hospitals NHS Foundation Trust)H-Index: 1
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Introduction Acromegaly is a chronic, debilitating and disfiguring condition with a significantly increased morbidity and mortality due to cardiovascular, as well as respiratory complications. Patients with acromegaly are usually diagnosed at the age of 40, however, the duration of symptoms can vary from 5 to 10 years before the formal diagnosis is confirmed. Recent advances in the field of acromegaly have improved survival significantly. A strong association between acromegaly and premalignant ...
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Purpose Colorectal neoplasms are well known to be a complication in cases of acromegaly; however, data on the prevalence of colorectal neoplasms in Asian patients with acromegaly are limited. Further, the factors associated with colorectal neoplasms in cases of acromegaly are controversial. Therefore, we aimed to clarify the prevalence of and factors associated with colorectal neoplasms in Japanese patients with acromegaly in a single center.
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#1Ali Riza KoksalH-Index: 6
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An increase in the prevalence of colorectal polyps and cancer is reported in patients with acromegaly. This trial is designed to determine whether there is an increase in the prevalence of colorectal polyps/cancer in Turkish acromegaly patients. Sixty-six patients, who were under follow-up with the diagnosis of acromegaly and underwent total colonoscopic examination, were enrolled in the study. Sixty-five age- and gender-matched patients with nonspecific complaints were selected as control. The ...
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Objective: The aim was to formulate clinical practice guidelines for acromegaly. Participants: The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), five experts in the field, and a methodologist. The authors received no corporate funding or remuneration. This guideline is cosponsored by the European Society of Endocrinology. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and...
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In March 2011, the Acromegaly Consensus Group met to revise and update the guidelines on the diagnosis and treatment of acromegaly complications. The meeting was sponsored by the Pituitary Society and the European Neuroendocrinology Association and included experts skilled in the management of acromegaly. Complications considered included cardiovascular, endocrine and metabolic, sleep apnea, bone diseases, and mortality. Outcomes in selected, related clinical conditions were also considered, and...
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Patients with acromegaly have higher prevalence of colorectal neoplasms. The pathogenetic mechanism is still unclear and may be related to sustained increase in serum GH-IGF1. We aimed to evaluate the proliferative and apoptotic markers in samples of colonic mucosa obtained during screening colonoscopic biopsy from patients with acromegaly and study their relationship to serum IGF-1 and GH levels. The study subjects included 32 patients with acromegaly (4 female), 10 healthy controls (irritable ...
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Acromegaly is a chronic disease caused by the excessive secretion of growth hormone (GH), and as a result, of insulin-like growth factor-1 (IGF-1). Untreated, the condition reduces the patients’ life expectancy and leads to a series of complications, among which an increased risk of carcinogenesis is considered most important. This paper is an analysis of the publications on the issue of the formation of neoplasms, both malignant and benign, in acromegalic patients. Although the influence of acr...
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Objective: To describe demographic and hormonal characteristics, comorbidities (diabetes mellitus and hypertension), therapeutic procedures and their effectiveness, as well as predictors of morbidity and mortality in a nationwide survey of Italian acromegalic patients. Design: Retrospective multicenter epidemiological study endorsed by the Italian Society of Endocrinology and performed in 24 tertiary referral Italian centers. The mean follow-up time was 120 months. Results: A total of 1512 patie...
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