Lynch syndrome is a prevalent hereditary cancer predisposition syndrome. While colorectal cancer is the most common gastrointestinal (GI) cancer in Lynch syndrome, there is also increased risk of gastric and small intestinal cancers. Recommendations for upper GI cancer surveillance in Lynch syndrome vary widely with limited data supporting effectiveness. Herein, we collected data on individuals with a diagnosis of Lynch syndrome seen at our tertiary care referral center. We identified individuals who underwent upper endoscopy and those with upper GI cancers, and associated demographics, genetic testing results, and endoscopic information. Standard statistical analyses were performed. Among 295 individuals with Lynch syndrome seen at our center, 217 (73.6%) underwent 660 total upper endoscopies. Of these 217, precancerous upper endoscopy findings included Barrett's esophagus (7, 3.2%), gastric intestinal metaplasia (18, 8.3%), and duodenal adenomas (4, 1.8%), and Helicobacter pylori was identified in 6 (2.8%). Upper GI cancers were diagnosed in 11 individuals (3.7%), including esophageal in 1, gastric in 6, and duodenal in 4. Five (1.7%) of these upper GI cancers were identified on surveillance. Individuals with upper GI cancers identified on surveillance were older at first surveillance endoscopy, with median age 63.3 versus 44.9 years (P < 0.001). Of the upper GI cancers detected on surveillance, 80% (4/5) occurred within 2 years of last upper endoscopy and 80% were stage I. In conclusion, upper endoscopy surveillance in Lynch syndrome identifies upper GI cancers. For individuals with Lynch syndrome who undergo upper GI surveillance, a short surveillance interval may be warranted.

中文翻译：

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Lynch 综合征的上消化道内窥镜监测可检测胃和十二指肠腺癌

林奇综合征是一种流行的遗传性癌症易感综合征。虽然结直肠癌是 Lynch 综合征中最常见的胃肠道 (GI) 癌症，但患胃癌和小肠癌的风险也会增加。Lynch 综合征上消化道癌症监测的建议差异很大，支持有效性的数据有限。在此，我们收集了在我们的三级医疗转诊中心就诊的林奇综合征患者的数据。我们确定了接受上消化道内窥镜检查的人和患有上消化道癌症的人，以及相关的人口统计学、基因检测结果和内窥镜信息。进行了标准统计分析。在我们中心就诊的 295 名 Lynch 综合征患者中，217 名（73.6%）接受了 660 次上消化道内窥镜检查。在这 217 个中，癌前上消化道内镜检查结果包括 Barrett 食管 (7, 3.2%)、胃肠化生 (18, 8.3%) 和十二指肠腺瘤 (4, 1.8%)，6 例 (2.8%) 发现幽门螺杆菌。11 人 (3.7%) 诊断出上消化道癌症，其中食管癌 1 例，胃癌 6 例，十二指肠癌 4 例。这些上消化道癌中有 5 例 (1.7%) 是在监测中发现的。在监测中发现的上消化道癌症患者在第一次监测内镜检查时年龄较大，中位年龄分别为 63.3 岁和 44.9 岁（P < 0.001）。在监测中检测到的上消化道癌症中，80% (4/5) 发生在上次上消化道内镜检查的 2 年内，80% 为 I 期。总之，林奇综合征的上消化道监测可识别上消化道癌症。对于接受上消化道监测的 Lynch 综合征患者，