West N E, Wise P E, Herline A J, Muldoon R L, Chopp W V, Schwartz D A
Inflammatory Bowel Disease Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Inflamm Bowel Dis. 2007 Sep;13(9):1129-34. doi: 10.1002/ibd.20172.
The coexistence of intestinal neoplasms with Crohn's disease (CD) has been reported, but the evidence of an increased risk of carcinoid tumor with Crohn's disease has been mixed. We present 4 patients with CD with associated carcinoid tumor.
The charts of 111 patients with CD who had undergone resection between June 2001 and March 2005 were reviewed. The number of incidental carcinoid tumors in patients who underwent an appendectomy was used as a control.
Four cases of carcinoid tumor discovered in patients at resection for CD were identified. None had metastatic disease or carcinoid syndrome. These included 1 cecal (1 mm), 2 appendiceal (3 and 7 mm), and 1 transverse colon (7 mm) carcinoid tumors. None of the carcinoid tumors were identified in regions of active Crohn's disease. The incidence of carcinoid tumor in patients with Crohn's disease was 4 of 111 (3.6%). In comparison, 3 of 1199 patients (0.25%) who had appendectomies were identified as having appendiceal carcinoid tumor. Crohn's disease was associated with an increased incidence of carcinoid tumor; OR 14.9 (95% CI 2.5-102.5), P<0.0001.
There was a significantly increased incidence of carcinoid tumor in our Crohn's patients compared to the control patients. None of the carcinoid tumors developed in areas of Crohn's disease. This suggests that the development of carcinoid tumors may be secondary to distant proinflammatory mediators, rather than a local inflammatory effect from adjacent Crohn's disease. Patients with CD may be at increased risk of developing a carcinoid tumor.
已有报道称肠道肿瘤与克罗恩病（CD）共存，但关于克罗恩病患者类癌肿瘤风险增加的证据并不一致。我们报告4例患有CD并伴有类癌肿瘤的患者。
回顾了2001年6月至2005年3月期间接受手术切除的111例CD患者的病历。将接受阑尾切除术患者中偶然发现的类癌肿瘤数量作为对照。
在因CD接受手术切除的患者中发现4例类癌肿瘤。均无转移性疾病或类癌综合征。这些肿瘤包括1例盲肠类癌（1毫米）、2例阑尾类癌（3毫米和7毫米）和1例横结肠类癌（7毫米）。在克罗恩病活动区域未发现类癌肿瘤。克罗恩病患者类癌肿瘤的发生率为111例中的4例（3.6%）。相比之下，1199例接受阑尾切除术的患者中有3例（0.25%）被诊断为阑尾类癌肿瘤。克罗恩病与类癌肿瘤发生率增加相关；比值比为14.9（95%可信区间2.5 - 102.5），P < 0.0001。
与对照患者相比，我们的克罗恩病患者类癌肿瘤发生率显著增加。类癌肿瘤均未在克罗恩病区域发生。这表明类癌肿瘤的发生可能继发于远处的促炎介质，而非相邻克罗恩病的局部炎症效应。CD患者发生类癌肿瘤的风险可能增加。
