JOURNAL OF FAMILIAL TUMORS
Online ISSN : 2189-6674
Print ISSN : 1346-1052
Incidence and Pathological Features of Tumors on Surveillance by Colonoscopy and Upper Gastroduodenal Endoscopy in Patients with Lynch Syndrome
Masami Arai , Taishi Ogawa, Akiko Chino, Kensuke Kuraoka, Yorimasa Yamamoto, Jyunko Fujisaki, Masahiro Igarashi, Masashi Ueno, Yoshiya Fujimoto, Hiroya Kuroyanagi, Masatoshi Oya, Naoki Hiki, Tetsu Fukunaga, Shigekazu Ohyama, Takeshi Sano, Kaoru Kato, Tomohiro Tsuchida, Noriko Motoi, Masamichi Katori, Noriko Yamamoto, Yo Kato, Yuichi Ishikawa, Toshiharu Yamaguchi, Tetsuichiro Muto
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Keywords: Lynch syndrome, HNPCC（hereditary nonpolyposis colorectal cancer）, surveillance, colorectal cancer, gastric cancer, duodenal cancer
JOURNAL OPEN ACCESS

2010 Volume 10 Issue 1 Pages 32-38

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Abstract
【Purpose】The incidence of colorectal cancers on colonoscopy was compared with that of upper gastrointestinal tract cancers on gastroduodenoscopy in patients with Lynch syndrome. The clinical significance of colonoscopy and gastroduodenoscopy as surveillance procedures was examined.【Materials and Methods】 Forty-two patients with Lynch syndrome who were followed up for more than 2 years as of the end of December 2009 were studied. Endoscopic findings during the last 5 years were evaluated, the incidence of gastrointestinal cancers was calculated, and the clinical and pathological findings of adenomas and cancers were studied.【Results and Discussion】Cancers of the colorectum （5 cases, 7 lesions）, stomach （4 cases, 5 lesions） and duodenum （2 cases, 2 lesions） were detected during follow-up. In addition, 57 colorectal adenomas were detectid and were removed by colonoscopic resection. The frequency of detecting cancers per endoscopic examination was 3.1 ％ for colonoscopy and 4.2 ％ for gastroduodenoscopy. The incidence of colorectal cancers was lower than that of gastric and duodenal cancers. This finding suggests that the resection of precancerous lesions such as colorectal adenomas effectively reduced the occurrence of colorectal cancers. Surgical treatment was required in 2 patients, both of whom had not undergone colonoscopy for more than 24 months before lesion detection. Therefore, annual colonoscopy is recommended for surveillance in patients with Lynch syndrome. On the other hand, early detection of gastric cancer was more difficult: although gastroscopy was performed with 1–2 year interval, all but one lesion had submucosal or deeper invasion. The frequency of finding early lesions was lower than that of colonoscopy. However, annual gastroduodenoscopy is now needed for the surveillance and early detection of upper gastrointestinal tract lesions in patients with Lynch syndrome.
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© 2010 The Japanese Society for Familial Tumors
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