Vilien M, Jørgensen M J, Ouyang Q, Schlichting P, Linde J, Riis P, Binder V
Medical Gastroenterological Department C, Herlev University Hospital, Denmark.
J Intern Med. 1991 Sep;230(3):259-63. doi: 10.1111/j.1365-2796.1991.tb00440.x.
Colonoscopic screening for neoplasia was performed in a regional group of ulcerative colitis patients with a disease duration of greater than or equal to 15 years. A total of 121 patients, aged less than 80 years, were invited to participate, of whom 100 (83%) accepted colonoscopy, including biopsies in 15 standard locations of the entire colon, plus additional biopsies from all visible lesions. Unequivocal dysplasia was found in one patient with extensive colitis and a disease duration of 31 years. A polyp with highly differentiated adenocarcinoma was found in the sigmoid colon of a patient with intermittent rectum involvement, 37 years after the ulcerative colitis diagnosis had been made. Biopsy specimens from the remaining 98 patients showed no signs of dysplasia or cancer. Thus the frequency of pre-malignant or malignant changes is very low compared with the results of similar studies, and the rationale for general colonoscopic surveillance programmes for such patients is open to question.
对一组病程大于或等于15年的溃疡性结肠炎患者进行了结肠镜检查以筛查肿瘤。共有121名年龄小于80岁的患者被邀请参与，其中100名（83%）接受了结肠镜检查，包括在整个结肠的15个标准部位进行活检，以及对所有可见病变进行额外活检。在一名患有广泛性结肠炎且病程为31年的患者中发现了明确的发育异常。在一名间歇性直肠受累患者的乙状结肠中发现了一个伴有高分化腺癌的息肉，该患者在溃疡性结肠炎诊断37年后被发现。其余98名患者的活检标本未显示发育异常或癌症迹象。因此，与类似研究结果相比，癌前或恶性变化的频率非常低，对此类患者进行常规结肠镜监测计划的基本原理值得怀疑。
