관상동맥폐색질환에 따른 대장 종양의 유병률과 위험인자 = Prevalence and Risk Factors of Colorectal Neoplasms according to Coronary Artery Obstructive Disease

다국어 초록 (Multilingual Abstract)

Background/Aims: Both colorectal neoplasm (CN) and coronary artery obstructive disease (CAOD) are prevalent and major leading causes of death in Korea. Although CN and CAOD share similar risk factors such as male gender,smoking, hyperlipidemia, diabetes mellitus, and obesity, few studies of both CN and CAOD have been reported. In this study, we evaluated clinical correlations between CN and CAOD. Methods: Between June 2003 and December 2007, 176 patients (Male: 101, average age: 62.1±9.7 yr) who underwent colonoscopy after or before coronary angiography were retrospectively enrolled. The colonoscopic findings (normal, adenoma, or cancer) of patients as well as clinical and laboratory data according to the extent of CAOD (normal, minimal CAOD, or CAOD) were compared. Results: CAOD negative, minimal CAOD, and CAOD patients totaled 36, 40, and 100, respectively. The presence of CN (adenoma and adenocarcinoma) in CAOD negative, minimal CAOD, and CAOD cases was 42%,48%, and 63%, respectively, which was significantly different (P＜0.05). In multivariate analysis, old age (≥60yr; P=0.03, odds ratio 2.47) and the presence of CAOD (P=0.02, odds ratio 4.11) were associated with the presence of CN. Conclusions: The prevalence of CN increased in proportion to the severity of CAOD. Colorectal cancer screening by fecal occult blood tests or colonoscopy should be a priority in patients with CAOD, particularly the elderly. (Intest Res 2011;9:112-116)

참고문헌 (Reference)

1 Keavney B. C, "reactive protein and the risk of cardiovascular disease" 342 : d144-, 2011

2 Klampfer L, "inflammation and colon cancer" 11 : 451-464, 2011

3 McMichael AJ, "endogenous and exogenous sex hormones, and colon cancer: a review and hypothesis" 65 : 1201-1207, 1980

4 Frishman WH, "Tobacco smoking, nicotine, and nicotine and non-nicotine replacement therapies" 3 : 365-377, 2001

5 Bouvier AM, "The natural history of colorectal cancer revisited" 26 (26): 56-61, 2002

6 Lakka HM, "The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men" 288 : 2709-2716, 2002

7 Chan AO, "Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease" 298 : 1412-1419, 2007

8 Loria V, "Myeloperoxidase: a new biomarker of inflammation in ischemic heart disease and acute coronary syndromes" 2008 : 135625-, 2008

9 Koretz R, "Meta-analysis: aspirin reduces risk for colon cancer and related mortality at 20 years, particularly when taken for ≥ 5 years" 154 : JC3-3, 2011

10 Terzić J, "Inflammation and colon cancer" 138 : 2101-2114, 2010

11 Neugut AI, "Coronary artery disease and colorectal neoplasia" 38 : 873-877, 1995

12 Byeon JS, "Colorectal neoplasm in asymptomatic Asians: a prospective multinational multicenter colonoscopy survey" 65 : 1015-1022, 2007

13 Chan AO, "Coexistence between colorectal cancer/adenoma and coronary artery disease: results from 1382 patients" 24 : 535-539, 2006

14 Kaneko R, "Clinico-epidemiologic study of the metabolic syndrome and lifestyle factors associated with the risk of colon adenoma and adenocarcinoma" 11 : 975-983, 2010

15 Recio-Mayoral A, "Chronic inflammation and coronary microvascular dysfunction in patients without risk factors for coronary artery disease" 30 : 1837-1843, 2009

16 Miniño AM, "Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System. Deaths: final data for 2004" 55 : 1-119, 2007

17 Reicher-Reiss H, "Boyko V, Modan B. Selectively increased risk of cancer in men with coronary heart disease" 87 : 459-462, 2001

18 Correa P, "Atherosclerosis and polyps of the colon. Quantification of precursors of coronary heart disease and colon cancer" 35 : 313-320, 1982

19 Wang YY, "Association between adenomas of rectosigmoid colon and metabolic syndrome features in a Chinese population" 20 : 1410-1415, 2005

20 Pignone M, "Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation" 121 : 2694-2701, 2010

21 Wan MX, "A statin-based inhibitor of lymphocyte function antigen-1 protects against ischemia/reperfusion-induced leukocyte adhesion in the colon" 140 : 395-401, 2003

22 Hai-Rim Shin, "2002 Annual Report of the Korea Central Cancer Registry: Based on Registered Data from 139 Hospitals" 대한암학회 36 (36): 103-114, 2004