Hata K, Watanabe T, Kazama S, Suzuki K, Shinozaki M, Yokoyama T, Matsuda K, Muto T, Nagawa H
Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Br J Cancer. 2003 Oct 6;89(7):1232-6. doi: 10.1038/sj.bjc.6601247.
Patients with long-standing ulcerative colitis (UC) are known to have an increased risk for the development of colorectal cancer (CRC). The aim of this study was to clarify the cumulative risk for the development of dysplasia or invasive cancer and the effectiveness of surveillance colonoscopy in the Japanese population. A total of 217 patients received a total of 1027 surveillance colonoscopies between January 1979 and December 2001 at the University of Tokyo hospital. Patients with invasive cancer found in the surveillance group were compared to those referred to our hospital from the other hospitals without surveillance colonoscopy. Surveillance colonoscopy confirmed 15 patients with definite dysplasia. Of these, five were proved to have invasive cancer in the resected specimens. The cumulative risk for the development of invasive cancer at 10, 20, and 30 years was 0.5, 4.1, and 6.1%, respectively, while that for the development of definite dysplasia at 10, 20, and 30 years was 3.1, 10.0, and 15.6%, respectively. All the patients with invasive cancer in the surveillance group remained alive, while three out of four patients in the nonsurveillance group died. Our surveillance programme is useful for detecting UC-associated CRC, and survival may be improved by surveillance colonoscopy.
已知长期溃疡性结肠炎（UC）患者患结直肠癌（CRC）的风险会增加。本研究的目的是阐明日本人群中发育异常或浸润性癌发生的累积风险以及监测结肠镜检查的有效性。1979年1月至2001年12月期间，共有217例患者在东京大学医院接受了总共1027次监测结肠镜检查。将监测组中发现的浸润性癌患者与未进行监测结肠镜检查而从其他医院转诊至我院的患者进行比较。监测结肠镜检查确诊了15例明确发育异常的患者。其中，5例在切除标本中被证实患有浸润性癌。10年、20年和30年时浸润性癌发生的累积风险分别为0.5%、4.1%和6.1%，而10年、20年和30年时明确发育异常发生的累积风险分别为3.1%、10.0%和15.6%。监测组中所有浸润性癌患者均存活，而未监测组的4例患者中有3例死亡。我们的监测方案有助于检测UC相关的CRC，监测结肠镜检查可能会提高生存率。
