CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(07): E622-E626
DOI: 10.1055/s-0043-111723
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Incidence of small bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy

Jasmijn F. Haanstra
1   Department of gastroenterology and hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
7   Department of gastroenterology and hepatology, Isala, Zwolle, The Netherlands
,
Abdul Al-Toma
2   Department of gastroenterology and hepatology, St Antonius Hospital, Nieuwegein, The Netherlands
,
Evelien Dekker
3   Department of gastroenterology and hepatology, Amsterdam Medical Center, Amsterdam, The Netherlands
,
Steven A.L.W Vanhoutvin
4   Department of gastroenterology and hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands
,
Fokko M. Nagengast
5   Department of gastroenterology and hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
,
Elisabeth M. Mathus-Vliegen
3   Department of gastroenterology and hepatology, Amsterdam Medical Center, Amsterdam, The Netherlands
,
Monique E. van Leerdam
4   Department of gastroenterology and hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands
6   Dept of gastroenterology and hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
,
Wouter H. de Vos tot Nederveen Cappel
7   Department of gastroenterology and hepatology, Isala, Zwolle, The Netherlands
,
Roeland A. Veenendaal
8   Department of gastroenterology and hepatology, Leiden University Medical Center, Leiden, The Netherlands
,
Annemieke Cats
4   Department of gastroenterology and hepatology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands
,
Silvia Sanduleanu
9   Department of gastroenterology and hepatology, Maastricht University Medical Center, Maastricht, The Netherlands
,
Hans F.A. Vasen
8   Department of gastroenterology and hepatology, Leiden University Medical Center, Leiden, The Netherlands
10   The Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands
,
Jan H. Kleibeuker
1   Department of gastroenterology and hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
,
Jan J. Koornstra
1   Department of gastroenterology and hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Weitere Informationen

Publikationsverlauf

submitted 15. Dezember 2016

accepted after revision 15. Mai 2017

Publikationsdatum:
06. Juli 2017 (online)

Abstract

Background and study aims Lynch syndrome (LS) patients have an increased risk of small bowel cancer. The question is whether surveillance will lead to early detection of (pre)malignant lesions. We recently reported on prevalence of small bowel neoplasia (SBN) in LS patients as assessed by video capsule endoscopy (VCE). The aim of this prospective study was to determine the incidence of SBN.

Patients and methods Asymptomatic LS patients who underwent a VCE were invited to undergo a second VCE procedure 2 years later. If abnormalities or polypoid lesions larger than 1 cm were detected, subsequent endoscopic procedures were performed.

Results A total of 155 (78 %) of the initial 200 patients underwent a second VCE procedure after a mean of 2.2 (range 1 – 6) years. In 17 of the 155 (11 %) patients possibly significant lesions were detected, which required further investigation by means of gastroduodenoscopy (n = 8) or balloon-assisted endoscopy (n = 9). These procedures revealed no SBN.

Conclusion No SBN was found after 2 years. Surveillance of the small bowel by VCE does not seem to be warranted in asymptomatic LS patients.

This study was registered in the Clinical Trials.gov registry with identifier NCT00898768.

 
  • References

  • 1 Lynch HT, Lynch PM, Lanspa SJ. et al. Review of the Lynch syndrome: history, molecular genetics, screening, differential diagnosis and medicolegal ramifications. Clin Genet 2009; 76: 1-18
  • 2 Koornstra JJ, Mourits MJ, Sijmons RH. et al. Management of extracolonic tumours in patients with Lynch syndrome. Lancet Oncol 2009; 10: 400-408
  • 3 Koornstra JJ, Kleibeuker JH, Vasen HF. Small-bowel cancer in Lynch syndrome: is it time for surveillance?. Lancet Oncol 2008; 9: 901-905
  • 4 ten Kate GL, Kleibeuker JH, Nagengast FM. et al. Is surveillance of the small bowel indicated for Lynch syndrome families?. Gut 2007; 56: 1198-1201
  • 5 Rodriguez-Bigas MA, Vasen HF, Lynch HT. et al. Characteristics of small bowel carcinoma in hereditary nonpolyposis colorectal carcinoma. International Collaborative Group on HNPCC. Cancer 1998; 83: 240-244
  • 6 Haanstra JF, Al-Toma A, Dekker E. et al. Prevalence of small-bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy. Gut 2015; 64: 1578-1583
  • 7 Saurin JC, Pilleul F, Soussan EB. et al. Small-bowel capsule endoscopy diagnoses early and advanced neoplasms in asymptomatic patients with Lynch syndrome. Endoscopy 2010; 42: 1057-1062
  • 8 Vasen HF, Abdirahman M, Brohet R. et al. One to 2-year surveillance intervals reduce risk of colorectal cancer in families with Lynch syndrome. Gastroenterology 2010; 138: 2300-2306
  • 9 Järvinen HJ, Aarnio M, Mustonen H. et al. Controlled 15-year trial on screening for colorectal cancer in families with hereditary nonpolyposis colorectal cancer. Gastroenterology 2000; 118: 829-834
  • 10 Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 2005; 37: 570-578
  • 11 Pan SY, Morrison H. Epidemiology of cancer of the small intestine. World J Gastrointest Oncol 2011; 3: 33-42