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Dig Dis Sci: 炎症性肠病和锯齿状息肉伴发育不良患者的结直肠肿瘤风险明显增加

2022-04-25 xuyihan MedSci原创

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。好发于直肠与乙状结肠交界处,以40~50岁年龄组发病率最高,男女之比为2~3:1。

结直肠癌 (CRC) 是结肠炎性肠病 (IBD) 最严重的并发症之一,其发病率估计是普通人群的 1.5-2 倍。因此,IBD 患者需要接受定期结肠镜检查以筛查癌前病变并预防 CRC的发生。CRC 最重要的危险因素之一是存在结肠炎相关的低度不典型增生 (LGD) 或高度不典型增生 (HGD),然而,目前尚不清楚 IBD 中结直肠锯齿状息肉的存在是否会影响结直肠肿瘤 (CRN) 的风险。

在一般人群中,大约 25% 的散发性 CRC 是由锯齿状息肉病变引起的,锯齿状息肉包括增生性息肉(HPs)、无蒂锯齿状病变(SSLs)和传统锯齿状腺瘤(TSA)。本项研究旨在表征 IBD 患者的锯齿状息肉发病率,并确定与 IBD 中锯齿状息肉存在相关的因素,以及评估患有锯齿状息肉的 IBD 患者的 CRN 风险。

为此,研究人员建立了一个患有和没有患有结肠锯齿状息肉的 IBD 患者的回顾性队列。使用时间相关变量的 Cox 回归分析来比较有和没有锯齿状息肉的 IBD 患者的晚期 CRN 的发生风险。

研究结果显示在 621 名入组的 IBD 患者中,198 名患有锯齿状息肉(92 名 HP,88 名无发育异常的 SSL,13 名患有发育不良的 SSL和 5 名 TSA)。与锯齿状息肉相关的独立因素是溃疡性结肠炎 (UC)(优势比 (OR) 1.77, 95% 置信区间 (CI) 1.19–2.62, p =0.005)、男性 (OR 1.63, 95% CI 1.11–2.40, p=0.013)和年龄较大(OR 1.06, 95%CI 1.05–1.08, p<0.001)。

伴有发育不良的 TSA 和 SSLs 是后续晚期 CRN 的危险因素(HR 13.51, 95% CI 3.11–58.68, p<0.001),而 HPs(HR 1.98, 95% CI 0.46–8.60, p=0.36)和无发育异常的 SSLs( HR 0.87, 95% CI 0.11–6.88, p=0.89)不影响随后的晚期 CRN 风险。

本项研究证实UC、男性和年龄较大与锯齿状息肉的存在有关。大多数锯齿状息肉 (91%) 是 HPs 和 SSL,没有发育异常,并且不影响 CRC 风险。然而,具有发育不良的 TSA 和 SSL与随后的晚期 CRN 发生相关。

 

原始出处:

Michiel E. de Jong. Et al. Increased Colorectal Neoplasia Risk in Patients with Inflammatory Bowel Disease and Serrated Polyps with Dysplasia. Digestive Diseases and Sciences .2022.

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  5. 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    2022-05-04 1482963am12暂无昵称

    学习了

    0

  6. 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content=<a href='/topic/show?id=f364e871840' target=_blank style='color:#2F92EE;'>#结直肠肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78718, encryptionId=f364e871840, topicName=结直肠肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78398366026, createdName=tamgche, createdTime=Tue Apr 26 08:21:39 CST 2022, time=2022-04-26, status=1, ipAttribution=)]
    2022-04-27 xulv123

    认真学习~

    0

  7. 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  8. 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    2022-04-26 neurowu
  9. 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结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。好发于直肠与乙状结肠交界处,以40~50岁年龄组发病率最高,男女之比为2~3:1。

BMC Gastroenterology: 结直肠癌根治性术后患者疾病复发的危险因素

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。

DCR:II期结肠癌壁外淋巴、血管和神经周围浸润对于患者预后的影响

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。好发于直肠与乙状结肠交界处,以40~50岁年龄组发病率最高,男女之比为2~3:1。

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