Piton Gaël, Cosnes Jacques, Monnet Elisabeth, Beaugerie Laurent, Seksik Philippe, Savoye Guillaume, Cadiot Guillaume, Flourie Bernard, Capelle Philippe, Marteau Philippe, Lemann Marc, Colombel Jean Frédéric, Khouri Elie, Bonaz Bruno, Carbonnel Franck
Service de Gastroentérologie et Nutrition, Centre Hospitalier Universitaire de Besançon, France.
Am J Gastroenterol. 2008 Jul;103(7):1730-6. doi: 10.1111/j.1572-0241.2008.01847.x. Epub 2008 Jun 28.
It is well established that Crohn's disease (CD) is associated with an increased risk of small bowel adenocarcinoma (SBA). The data concerning SBA risk factors in CD are scanty. The aim of this study was to identify them.
In 11 French centers affiliated with the GETAID (Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif), we identified 29 patients with CD and SBA. Eighty-seven CD controls without SBA recruited in a single center were matched to the cases for sex, age, duration, and CD site. A conditional logistic regression, taking into account the matching between cases and controls, was performed.
In univariate analysis, the cases had had significantly less small bowel resection and received prolonged treatment with salicylates (more than 2 yr), less often than the controls (odds ratio, OR [95% confidence interval, CI] 0.07 [0.01-0.32] and 0.29 [0.10-0.82], respectively). In multivariate analysis, both associations remained significant (OR 0.04 [0.01-0.28], P= 0.001; OR 0.16 [0.03-0.79], P= 0.02, respectively).
This study suggests that small bowel resection and prolonged salicylates use may protect against SBA in CD patients.
克罗恩病（CD）与小肠腺癌（SBA）风险增加相关，这一点已得到充分证实。关于CD患者SBA风险因素的数据较少。本研究旨在确定这些风险因素。
在隶属于GETAID（消化管炎性疾病治疗研究组）的11个法国中心，我们确定了29例患有CD和SBA的患者。在单一中心招募的87例无SBA的CD对照，在性别、年龄、病程和CD病变部位方面与病例进行匹配。进行了条件逻辑回归分析，并考虑了病例与对照之间的匹配情况。
在单因素分析中，病例组接受小肠切除术的次数显著少于对照组，接受水杨酸类药物长期治疗（超过2年）的频率也低于对照组（优势比，OR [95%置信区间，CI]分别为0.07 [0.01 - 0.32]和0.29 [0.10 - 0.82]）。在多因素分析中，这两种关联仍然显著（OR分别为0.04 [0.01 - 0.28]，P = 0.001；OR为0.16 [0.03 - 0.79]，P = 0.02）。
本研究表明，小肠切除术和长期使用水杨酸类药物可能对CD患者预防SBA具有保护作用。
