Abstract
In order to evaluate the prevalence of duodenal adenomas in familial adenomatous polyposis (FAP) and the risk of carcinoma development, a multicenter study was initiated in Denmark, Finland, Holland, Norway and Sweden, which have national polyposis registers with an almost complete registration. Patients aged 20 years or more are being examined with biennial gastroduodenoscopy during 1990–2000. Multiple duodenal biopsies are examined by one pathologist from each country, and the endoscopic and histological criteria of Spigelman have been adopted. At the end of August 1992, 312 patients with a median age of 37 years (range 20–86) had completed their first endoscopy. The duodenum was examined in 310 patients, of whom 199 (64%) had duodenal adenomas. Twenty-two patients (11% of all patients with duodenal adenomas) had no endoscopically visible polyps. One patient had an asymptomatic adenocarcinoma. The Spigelman stage worsened significantly (P<0.05) with time from the diagnosis of FAP, which may suggest an increasing risk of carcinoma by time.
Résumé
Afin d'évaluer la prévalence des adénomes duodénaux chez des sujets porteurs d'une polypose adénomateuse familiale, et établir le risque d'un développement d'un cancer, une étude multicentrique a été débutée an Danemark, Finlande, Hollande, Norvége et Suède, pays qui possèdent un registre national des polyposes avec un enregistrement le plus souvent complet. Les patients âgés de 20 ans ou plus seront examinés tous les deux ans par une gastro-duodénoscopie de 1990 à 2000. De multiples biopsies duodénales sont examinées par un seul pathologue par pays et les critères endoscopiques et histologiques de Spigelman ont été retenus. A la fin du mois d'août 1992, 312 patients dont l'âge moyen est de 37 ans (20 à 86) ont complété leur première endoscopie. Le duodénum a été examiné chez 310 patients dont 199 (64%) étaient porteurs d'adénomes duodénaux. Vingt-deux patients (11% de tous les patients porteurs d'adénomes duodénaux) étaient porteurs de polypes visibles à l'endoscopie. Un patient était porteur d'un adéno-carcinome asymptomatique. Le stade de Spigelman se péjorait de manière significative (P<0.05) avec le temps qui s'écoule depuis le diagnostic de la FAP, ce qui peut suggérer un risque accru de cancers avec la durée d'évolution.
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The DAF Project Group includes the present authors and A. Mellon Mogensen, F. Moesgaard, L. B. Svendsen, J. Søndergaard and L. Karlsen (Denmark), J.-P. Mecklin and A. Kahri (Finland), G. Griffioen, F. Nagengast and G.J.A. Offerhaus (Holland), A. Bakka, S. Norheim Andersen (Norway), C. Rubio (Sweden)
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Bülow, S., Alm, T., Fausa, O. et al. Duodenal adenomatosis in familial adenomatous polyposis. Int J Colorect Dis 10, 43–46 (1995). https://doi.org/10.1007/BF00337586
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DOI: https://doi.org/10.1007/BF00337586