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Gut:溃疡性结肠炎持续活动性炎症负担与结直肠肿瘤

2017-11-20 zhangfan MedSci原创

研究认为溃疡性结肠炎患者持续的结直肠活动性炎症导致患者肿瘤风险显著增加,有计划的结肠镜检查对患者病情监控具有指导意义

溃疡性结肠炎(UC)的病情一直处于持续变化过程中。近日研究人员考察了溃疡性结肠炎累积的炎症负担对结直肠肿瘤风险(CRN)的影响。

本研究为回顾性单中心研究。2003-12年间接受结肠镜检查的UC患者参与,通过内镜评价患者肠道炎症症状 (0为无活动性炎症; 1为轻微炎症; 2为中度炎症; 3重度炎症)。累积炎症负担(CIB)使用单位时间内检查的平均值进行评估,利用Cox潜在预测因子评估CIB与 CRN 的关系。

总计987名患者,进行为期13年的随访,共97人(9.8%)发展为结直肠肿瘤。多变量分析显示累积炎症负担与结直肠肿瘤进展显著相关,持续轻度、中度或严重的活动性炎症分别导致患者10、5、3.3年后结直肠肿瘤风险提高(95%,CI 1.4-3.0;P<0.001)。独立的不连续结肠镜检测对肿瘤的预测效果不显著(得分每增加1分的肿瘤风险为0.9 ,95%,CI 0.7- 1.2; P=0.5),而5年的结肠镜炎症平均得分与结直肠肿瘤风险显著相关 (得分每增加1分的肿瘤风险为2.2,95%,CI 1.6- 3.1; P<0.001)。

研究认为溃疡性结肠炎患者持续的结直肠活动性炎症导致患者肿瘤风险显著增加,有计划的结肠镜检查对患者病情监控具有指导意义。

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    2017-12-31 nymo
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