Tougeron David, Lefebure Benoit, Savoye Guillaume, Tuech Jean Jacques, di Fiore Frederic, Michel Pierre
Department of Hepatogastroenterology, Rouen University Hospital, Northwest Canceropole, France.
Scand J Gastroenterol. 2008;43(11):1397-400. doi: 10.1080/00365520801918042.
Patients affected with Crohn's disease (CD) have a recognized, but low relative risk of developing small-bowel adenocarcinoma (SBA). In fact, SBA develops in 2.2% of patients who have long-standing CD and it is seldom diagnosed preoperatively because of its rarity. A retrospective analysis of all cases of SBA in CD patients since 1980 was carried out in Rouen University Hospital. Three patients with known or unknown CD who presented with SBA with long-term follow-up were analysed. In our first case, the occlusive syndrome revealed SBA and CD simultaneously. Most ileal carcinomas in CD are located in strictures and are often incidentally diagnosed postoperatively, as in our three cases. Digestive surgeons and gastroenterologists must be aware that the diagnosis of SBA in CD is often made fortuitously on histological examination after surgical resection for an occlusive syndrome. Failure to detect SBA in patients with CD results in late diagnosis, with poor survival.
患有克罗恩病（CD）的患者发生小肠腺癌（SBA）的相对风险已得到公认，但较低。事实上，长期患CD的患者中，SBA的发病率为2.2%，由于其罕见性，术前很少被诊断出来。鲁昂大学医院对自1980年以来CD患者中所有SBA病例进行了回顾性分析。对3例已知或未知患有CD且出现SBA并接受长期随访的患者进行了分析。在我们的第一个病例中，闭塞综合征同时揭示了SBA和CD。CD患者的大多数回肠癌位于狭窄部位，通常在术后偶然被诊断出来，我们的3个病例就是如此。消化外科医生和胃肠病学家必须意识到，CD患者的SBA诊断通常是在因闭塞综合征进行手术切除后通过组织学检查偶然做出的。未能在CD患者中检测到SBA会导致诊断延迟，生存率低。
