Delaunoit Thierry, Limburg Paul J, Goldberg Richard M, Lymp James F, Loftus Edward V
Department of Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Clin Gastroenterol Hepatol. 2006 Mar;4(3):335-42. doi: 10.1016/j.cgh.2005.12.035.
BACKGROUND & AIMS: Inflammatory bowel disease (IBD) is associated with an increased risk for colorectal cancer (CRC). However, the genetic, endoscopic, and histologic features of IBD-associated CRC differ from cancers that arise sporadically. The objectives of this study were to describe the clinicopathologic features of IBD-associated CRC and to compare survival rates between patients with IBD-associated CRC and patients with sporadic CRC.
There were 290 patients with IBD-associated CRC (241 with chronic ulcerative colitis [CUC] and 49 with Crohn's disease) and an equal number of age- and sex-matched sporadic CRC patients who were evaluated at the Mayo Clinic between 1976 and 1996. Medical records were reviewed retrospectively for demographic features, endoscopic and histologic characteristics, and vital status at the time of the last follow-up evaluation. The actuarial survival of each group was calculated by the Kaplan-Meier method. The influence of clinical features on survival was assessed using Cox proportional hazards regression modeling.
The median age at diagnosis of IBD-related CRC was 48 years. Fifty-five percent of IBD-related tumors were distal to the splenic flexure compared with 78% of sporadic tumors. During a median follow-up period of 5 years, 163 IBD-associated CRC patients died (56%), compared with 164 sporadic CRC patients (57%). The 5-year survival rates were 54% in the IBD-CRC subgroup vs 53% in the sporadic CRC subgroup (P = .94, log-rank).
CUC-related CRC is diagnosed at a relatively young age, and IBD-related tumors tend to be distributed more evenly across the colorectum than sporadic tumors. The survival rates for IBD-associated and sporadic CRC were similar.
炎症性肠病（IBD）与结直肠癌（CRC）风险增加相关。然而，IBD相关CRC的遗传、内镜及组织学特征与散发性结直肠癌不同。本研究的目的是描述IBD相关CRC的临床病理特征，并比较IBD相关CRC患者与散发性CRC患者的生存率。
选取1976年至1996年间在梅奥诊所接受评估的290例IBD相关CRC患者（241例慢性溃疡性结肠炎[CUC]患者和49例克罗恩病患者）以及数量相等、年龄和性别匹配的散发性CRC患者。回顾医疗记录以获取人口统计学特征、内镜及组织学特征，以及最后一次随访评估时的生命状态。采用Kaplan-Meier法计算每组的精算生存率。使用Cox比例风险回归模型评估临床特征对生存的影响。
IBD相关CRC诊断时的中位年龄为48岁。IBD相关肿瘤55%位于脾曲远端，而散发性肿瘤这一比例为78%。在中位随访期5年期间，163例IBD相关CRC患者死亡（56%），散发性CRC患者为164例（57%）。IBD-CRC亚组的5年生存率为54%，散发性CRC亚组为53%（P = 0.94，对数秩检验）。
CUC相关CRC在相对年轻的年龄被诊断，且IBD相关肿瘤在结直肠的分布比散发性肿瘤更均匀。IBD相关CRC和散发性CRC的生存率相似。
