Clinical Value of Distal Colon Polyps for Prediction of Advanced Proximal Neoplasia: The KASID Prospective Multicenter Study

Keum, Bora; Jeen, Yoon Tae; Choi, Jai Hyun; Jung, Sung-Ae; Kim, Hyun Soo; Kim, Young-Ho; Kim, Won Ho; Kim, Tae Il; Kim, Hyo Jong; Yang, Suk Kyun; Myung, Seung Jae; Byeon, Jeong Sik; Lee, Moon Sung; Jung, Il Kwon; Chung, Moon Kwan; Choi, Hwang; Han, Dong Soo; Song, Jae Suk

Original Article

Intestinal Research 2005;3(2):121-126.
Published online December 30, 2005.

Clinical Value of Distal Colon Polyps for Prediction of Advanced Proximal Neoplasia: The KASID Prospective Multicenter Study

Bora Keum, Yoon Tae Jeen, Jai Hyun Choi, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Hwang Choi, Dong Soo Han, Jae Suk Song

^*Department of Internal Medicine, Korea University College of Medicine
^†Ewha Womans University
^‡Seoul, Yonsei University
^§Wonju, Sungkyunkwan University
^∥Seoul, Yonsei University
^¶Seoul, Kyunghee University
^*Seoul, Ulsan University
^††Seoul, Soonchunhyang University
^‡‡Bucheon and Chonnan, Youngnam University
^§§Daegu, Catholic University
^∥∥Bucheon, Hanyang University
^¶¶Guri, and Department of Preventive Medicine, Kwandong University College of Medicine, Gangneung, Korea

대장 근위부 진행성 선종 예측을 위한 원위부 용종의 임상적 의의: 전향적 다기관 대장 용종 연구

금보라, 진윤태, 최재현, 정성애, 김현수, 김영호, 김원호, 김태일, 김효종, 양석균, 명승재, 변정식, 이문성, 정일권, 정문관, 최황, 한동수, 송재석

^*고려대학교 의과대학
^†이화여자대학교 의과대학
^‡연세대학교 원주의과대학
^§성균관대학교 의과대학
^∥연세대학교 의과대학
^¶경희대학교 의과대학
^*울산대학교 의과대학
^††순천향대학교 의과대학
^‡‡영남대학교 의과대학
^§§가톨릭대학교 의과대학
^∥∥한양대학교 의과대학 내과학교실
^¶¶관동대학교 의과대학 예방의학교실

Abstract

Backgroud/Aims: Proximal lesion without distal finding is weak point in colon cancer screening. Clinical significance of distal finding for advanced proximal neoplasia (APN) is uncertain. Aims of this study were to assess distal finding for prediction of APN. Methods: Asymptomatic 826 adults (age≥50) were collected in KASID prospective study, who underwent colonoscopy and polypectomy. Polyps located distal to splenic flexure were defined as distal polyps. Age, gender, size, appearance, histology of distal polyps were analyzed as risk factor of APN (adenoma≥10 mm or villous histology or high grade dysplasia or invasive cancer). Sensitivity and positive predictive value of distal polyp on APN were assessed. Results: APN were found in 98 patients and 45 (45.9%) patients of them were not associated with any distal findings. Risk factors of APN were male, size of distal polyp and advanced distal polyp. Sensitivity of distal polyp size≥10 mm on APN was 38.8% and advanced distal polyp also 38.8%. Positive predictive value of distal polyp size≥10 mm and advanced distal polyp were 13.3%, 14.4% respectively. Conclusions: Although distal colon findings were helpful to predict APN in asymptomatic 50 years of age or order patients screening, more careful examination is required considering APN without distal polyps. (Intestinal Research 2005;3:121-126)

Key Words: Distal colon polyp, Advanced proximal neoplasia