据3月5日《美国医学协会期刊》（JAMA）上的一则研究显示，扁平非息肉样结肠直肠新生物（NP-CRNs）可能难以发现，但它们看来还是比较常见，且其与更为常规诊断的结肠直肠息肉性病变相比与癌症的关系更大。
结肠直肠癌是美国癌症死亡中排名第二的原因。对此病的预防聚焦在对息肉样（外观类似息肉）新生物（一种新的异常生长物）的发现与移除上。但是，最近的研究证明了结肠直肠癌也可能来自NP-CRNs。
美国加州Veterans Affairs Palo Alto卫生保健系统的Roy M. Soetikno及其同僚对一组经历了选择性结肠镜检查的1819位病人的数据进行了检验，以估测NP-CRNs的发病率，并对NP-CRNs与结场直肠癌的相关性进行了调查。
作者在文章中写道：“我们的结论是，在某单一的Veterans Affairs医院的病患人群中，NP-CRNs在结肠镜检查时相对较为常见。它们比息肉样新生物更可能含有癌性病变，而这种特性与病变的大小无关。最近的研究已经发现了非息肉样与息肉性结肠直肠肿瘤间的基础遗传机制方面的差别。未来对NP-CRNs的研究应该进一步评估诊断去除NP-CRNs对结肠直肠癌的预防及死亡率是否有任何的作用，并特别关注其在遗传及蛋白质方面的异常性。”（来源：EurekAlert!中文版）
生物谷推荐原始出处：
（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.
