生活方式與飲食習慣與大腸息肉的相關性

Correlation between lifestyle and eating habits with colorectal polyps

陳雅玲(Chen-Ya ling 陳雅玲)

指導教授 ： 林俊哲

中山醫學大學/醫學院/醫學研究所/碩士(2017年)

摘要

大腸直腸癌罹患人數居105年全國癌症死亡原因第三位、發生率有逐年升高的情形，但若能早期發現，早期治療，其治癒率是非常高的。近年來因國人生活習慣的改變及飲食習慣精緻化及西化，導致大腸內的息肉易演變成具有高度癌化風險的腺瘤性息肉。大腸息肉轉變成大腸癌所需時間，因致癌途徑的不同亦不同、罹癌時間亦不同、了解生活方式和飲食習慣與大腸息肉的相關性，以預防為前題找出與息肉有關的相關因子，希望有效預防息肉演變成大腸癌。
本研究利用大腸鏡檢查的就醫個案所收集的「大腸鏡檢查評估問卷資料」共442份。問卷設計係由腸胃科醫師專家整理出與大腸息肉相關的四大類危險因子，分別為第一類、基本資料，第二類、慢性病史，第三類、家族病史，第四類、生活習慣等。結果發現性別、年齡、身高、體重、腰圍、及身體質量指數、腰臀圍比與息肉有明顯相關。個案出現排便型態改變、有裡急後重症狀、有大腸息肉病史、脂肪肝、高血壓及高血脂等與息肉有明顯相關。本研究中發現個案如有抽煙、喝酒及嚼檳榔的習慣與大腸息肉有明顯相關性；即使個案戒煙1-5年，或已戒酒仍有較高的比例被診斷有大腸息肉。
在臨床上若能針對風險性較高的患者安排大腸鏡的檢查、以便早期發現結腸腫瘤進而進行切除、逹到次級預防大腸惡性腫瘤的發生或是及早診斷大腸惡性腫瘤早期接受治療。

關鍵字

生活方式 ； 飲食習慣 ； 大腸息肉

並列摘要

Colorectal cancer, the number of deaths in 105 years the third cause of cancer deaths in Taiwan、The incidence rate has increased year by year，but if early detection， early treatment， the cure rate is very high。In recent years due to changes in people's living habits and eating habits of refined and Westernized leading to large intestine polyps easily evolved into a high degree of cancer risk of adenomatous polyps。Colorectal polyps into colorectal cancer time，due to different carcinogenic routes are different，cancer time is also different，und- erstanding of lifestyle and eating habits and colorectal polyps related to the pr- evention of the premise to find the relevant factors related to polyps，Hoping to effectively prevent the evolution of polyps into colorectal cancer。
In this study，a total of 442 copies of the "Colonoscopy Examination Ass- essment of questionnaire data" were collected from the medical examination of colonoscopy。Questionnaire design by the Department of Gastroenterologists experts and coliform polyps related to the four major categories of risk factors namely，the first category，basic information；the second category，chronic history；the third category，family history；the fourth category，lifestyle。The results showed that gender、age、height、weight、waist circumference、and the body mass index，waist and hip circumference were significantly correlated with polyps。
Cases have change in bowel habits、rectal tenesmus、history of colorectal polyps、fatty liver、high blood pressure and high cholesterol and polyp were significantly related。In this study，it was found that cases such as smoking，drinking and chewing betel nut had a clear correlation with colorectal polyps。Even if the case quit smoking for 1 to 5 years，or have a high proportion of alcohol has been diagnosed with colorectal polyps。
If the clinical risk of patients with colorectal cancer can be arranged in order to early detection of colonic tumors and then removed，to the secondary prevention of colorectal malignancy or early diagnosis of colorectal cancer early treatment。

並列關鍵字

lifestyle ； eat habits ； colorectal polyps

參考文獻

林鵬展,李政昌.(2008).大腸直腸癌的分子生物學及訊息傳遞路徑.中華癌

Chung YW, Han DS, Park YK, Son BK, Paik CH, Lee HL, et al. Association of obesity, serum glucose and lipids with the risk of advanced colorectal adenoma and cancer: a case-control study in Korea. Dig Liver Dis 2006;38:668-72.

Chiu HM, Lin JT, Shun CT, Liang JT, Lee YC, Huang SP, Wu MS. “Associat -ion of metabolic syndrome with proximal and synchronous colorectal neoplasm,”Clin Gastroenterol Hepatol. 2007 Feb;5(2):221-9; quiz 141. Epub 2006 Aug 22. Bethesda MD. SEER Cancer Statistics Review 1975-2010. 


Eden JA, Abrams KR, Mayberry JF:The true risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001 Apr, 48(4):526-35.

Esteve E, Ricart W, Fernandez-Real JM. Dyslipidemia and inflammation: an evolutionary conserved mechanism. Clin Nutr 2005;24:16-31.