Khorrami Mashhadi S, Trapero M, Gisbert J P, Gómez Domínguez E, Maté Jiménez J
Service of Digestive Diseases, Hospital Universitario de La Princesa, Madrid, Spain.
Rev Esp Enferm Dig. 2005 Jan;97(1):16-23. doi: 10.4321/s1130-01082005000100003.
Patients with ulcerative colitis (UC) have a greater risk of developing colorectal cancer (CRC) when compared to the general population. Epithelial dysplasia comes before this neoplasm, and thus endoscopic surveillance is recommended to these patients. This pilot study aims at establishing the incidence of dysplasia and CRC in patients with long-standing UC in our hospital.
This is a prospective observational study performed in patients with a definite diagnosis of UC for more than 8 years. These patients were encouraged to enroll in an endoscopic surveillance program for CRC. All patients underwent colonoscopy and multiple biopsies every 18 to 24 months in order to detect epithelial dysplasia.
Thirty-nine patients were included from January 1994 to December 2003. Half of them were males. Mean age was 52 +/- 13 years. Mean duration of UC was 15 +/- 8 years. Thirteen (35%) patients had left colitis, and 26 (65%) had pancolitis or extensive colitis. The presence of mild dysplasia was detected in four patients, on two occasions in one of them (13%; 95% CI: 6.1-33.5); the incidence of mild dysplasia was 1.3% patients per surveillance year. No severe dysplasia or CRCs were identified.
The incidence of dysplasia in our area is lower than expected, and does not support surveillance programs for these patients. However, no definite conclusions may be drawn from such a small number of patients.
与普通人群相比，溃疡性结肠炎（UC）患者患结直肠癌（CRC）的风险更高。上皮发育异常先于这种肿瘤出现，因此建议对这些患者进行内镜监测。这项初步研究旨在确定我院长期患UC患者中发育异常和CRC的发生率。
这是一项针对确诊为UC超过8年的患者进行的前瞻性观察性研究。鼓励这些患者参加CRC的内镜监测项目。所有患者每18至24个月接受一次结肠镜检查和多次活检，以检测上皮发育异常。
1994年1月至2003年12月共纳入39例患者。其中一半为男性。平均年龄为52±13岁。UC的平均病程为15±8年。13例（35%）患者患有左半结肠炎，26例（65%）患有全结肠炎或广泛性结肠炎。4例患者检测到轻度发育异常，其中1例有两次检测到（13%；95%可信区间：6.1 - 33.5）；轻度发育异常的发生率为每监测年1.3%患者。未发现重度发育异常或CRC。
我们地区发育异常的发生率低于预期，不支持对这些患者进行监测项目。然而，从如此少量的患者中无法得出明确结论。
