The Role of Colonoscopy in patients with Early Gastric Cancer = The Role of Colonoscopy in patients with Early Gastric Cancer

다국어 초록 (Multilingual Abstract)

Background & Aims: Our purpose was to study the incidence of high grade dysplasia and colorectal cancer in patients with early gastric cancer (EGC) who underwent endoscopic submucosal dissection (ESD) compared to healthy controls. And we evaluated the necessity of colonoscopic surveillance in patients with early gastric cancer (EGC). Methods: The study group included a total of 185 patients with EGC that underwent ESD. As a control group, 442 sex and age-matched patients without gastric neoplasm were included. All of the patients underwent screening colonoscopy before or after 6months from gastric ESD between January 2010 and February 2014. Results: High grade dysplasia was diagnosed in 57/185 patients (30.8%) in EGC group and 17/442 (3.8%) in controls (p＜0.01). Colorectal cancer was diagnosed in 26/185 patients (14.0%) in EGC group and 8/442 (1.8%) in controls (p＜0.01). Univariate analysis demonstrated that high grade dysplasia was associated with presence of EGC, age, DM, and colorectal cancer was associated with presence of EGC, colorectal cancer family history. Multivariate analysis demonstrated that age (OR 6.34, 95% CI 3.4-11.5), EGC (OR 7.51, 95% CI 4.52-18.1) were risk factors for high grade dysplasia. And the presence of EGC (OR 6.51, 95% CI 2.91-14.90), aging (OR 3.71, 95% CI 1.58-10.91), colorectal cancer family history (OR 3.07, 95% CI 1.93-9.41) were risk factors for colorectal cancer. Conclusions: The incidence of high grade dysplasia and colorectal cancer in the EGC group who underwent gastric ESD was higher than that in the control group. Therefore, we suggest that a screening colonoscopy should be considered in patients with EGC undergoing ESD.