Jess T, Winther K V, Munkholm P, Langholz E, Binder V
Department of Medical Gastroenterology, Herlev Hospital, University of Copenhagen, Denmark.
Aliment Pharmacol Ther. 2004 Feb 1;19(3):287-93. doi: 10.1111/j.1365-2036.2004.01858.x.
To determine the long-term risk of intestinal and extra-intestinal malignancies in Crohn's disease patients in Copenhagen County, Denmark.
In Copenhagen County, a strictly population-based cohort of 374 patients with Crohn's disease diagnosed between 1962 and 1987 was followed until 1997 in order to determine the long-term risk of intestinal and extra-intestinal malignancies. Information on cancer occurrence was provided by the Danish National Cancer Registry and confirmed by the examination of hospital files. The observed number of cases was compared with the expected number, calculated from individually computed person-years at risk and 1995 cancer incidence rates for the background population.
The risk of small bowel adenocarcinoma was significantly increased, independent of age and gender (standardized morbidity ratio, 66.7; 95% confidence interval, 18.1-170.7). The risk of colorectal cancer was not increased, either in the total group of patients or in patients with colonic Crohn's disease exclusively (standardized morbidity ratio, 1.64; 95% confidence interval, 0.20-5.92). Extra-intestinal cancer did not occur more frequently than expected.
This population-based study of patients with Crohn's disease revealed no increase in colorectal cancer risk, possibly due to maintenance treatment with 5-aminosalicylic acid preparations and surgery in treatment failure. In contrast, the risk of small bowel cancer was increased more than 60-fold, but the numbers were small. The risk of extra-intestinal cancer was not increased and no lymphomas were observed.
确定丹麦哥本哈根郡克罗恩病患者发生肠道和肠外恶性肿瘤的长期风险。
在哥本哈根郡，对1962年至1987年间确诊的374例克罗恩病患者进行了严格基于人群的队列研究，随访至1997年，以确定肠道和肠外恶性肿瘤的长期风险。癌症发生信息由丹麦国家癌症登记处提供，并通过查阅医院档案进行确认。将观察到的病例数与预期数进行比较，预期数根据个体计算的风险人年数和1995年背景人群的癌症发病率计算得出。
小肠腺癌风险显著增加，与年龄和性别无关（标准化发病比，66.7；95%置信区间，18.1 - 170.7）。无论是在全部患者组还是仅患有结肠克罗恩病的患者中，结直肠癌风险均未增加（标准化发病比，1.64；95%置信区间，0.20 - 5.92）。肠外癌症的发生频率并未高于预期。
这项基于人群的克罗恩病患者研究显示，结直肠癌风险未增加，这可能归因于5 - 氨基水杨酸制剂的维持治疗以及治疗失败时的手术。相比之下，小肠癌风险增加了60多倍，但病例数较少。肠外癌症风险未增加，且未观察到淋巴瘤。
