Die Koloskopiefalle: Intervallkarzinome und übersehene Befunde – Neoplasien mit besonders aggressivem Wachstum

Zusammenfassung

Immer wieder erkranken Patienten, bei denen zuvor eine unauffällige Koloskopie durchgeführt wurde, an einem sogenannten Intervallkarzinom. Es stellt sich die Frage, wie diese Zahl vermin­dert werden kann, oder ob es sich um ein tumorbio­logisch bedingtes, aggressiveres Wachstum ­bestimmter Subtypen handelt. Das „Über­sehen“ ­eines Karzinom oder einer Vorläuferläsion ist ­unter bestimmten Voraussetzungen sowohl untersucher- als auch patientenbedingt möglich. Verschiedene Tumor-Phäno- und Genotypen müssen jedoch genauso bezüglich ihrer Vorläuferläsionen, Entwicklungsgeschwindigkeit und Aggressivität unterschieden werden, wie auch hinsichtlich ihrer koloskopischen Detektierbarkeit.

Abstract

With a remarkable frequency patients develop a so called interval-carcinoma after a colonoscopy without any relevant findings. Ways to minimize the incidence rate are desirable. Further it is of great interest to show if special tumour entities have a more aggressive growth behaviour. The colonoscopic missing of a carcinoma or a preneoplastic lesion can occur under several conditions which could be attributed to patients as well as to the observer. Despite this, different pheno- or genotypes of carcinoma have to be distinguished in regard to specific preneoplastic lesions, growth-rate, aggressiveness and the colonoscopical detection.

Schlüsselwörter

kolorektales Karzinom - Adenom-Karzinom-Sequenz - Serrated-Pathway - flache Karzinome - Inflammation-Karzinom-Sequenz - Mikrosatelliteninstabilität

Key words

colorectal cancer - adenoma-carcinoma-sequence - serrated pathway - flat carcinoma - inflammation-carcinoma-sequence - microsatellite instability

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