Ikeuchi Hiroki, Nakano Hiroki, Uchino Motoi, Nakamura Mitsuhiro, Matsuoka Hiroki, Fukuda Yoshihiro, Matsumoto Takayuki, Takesue Yoshio, Tomita Naohiro
Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.
Hepatogastroenterology. 2008 Nov-Dec;55(88):2121-4.
We investigated Crohn's Disease (CD) patients with carcinomas in the intestinal tract to emphasize the difficulty in establishing a diagnosis, as well as show the importance of establishing formal guidelines for screening and surveillance of cancers associated with perianal CD.
We studied 504 CD patients treated in our department with surgical intervention.
In 9 of the patients, carcinomas developed in relation to CD, 7 of whom had cancer of the lower rectum and anus with severe anorectal CD lesions. Five of 6 patients with advanced carcinoma in the anorectal region were treated using preoperative chemoradiation therapy and all 7 with anorectal carcinomas underwent an abdominoperineal resection. Two patients with a carcinoma of the fistula in the ileo-rectum or ileo-sigmoid colon were treated by a partial resection of the small and large bowel with the fistula. Mucinous cell type carcinomas were present in 6 patients, while signet ring cell type was found in 2 patients and poorly differentiated adenocarcinoma in 1. Three died prior to the follow-up examination.
There was an increased incidence of carcinoma in the intestinal tracts of patients with CD. It is important to establish a surveillance program for CD patients, especially those complicated with severe anorectal CD lesions.
我们对患有肠道癌的克罗恩病（CD）患者进行了调查，以强调诊断的困难，并展示为与肛周CD相关的癌症建立筛查和监测正式指南的重要性。
我们研究了在我们科室接受手术干预治疗的504例CD患者。
9例患者发生了与CD相关的癌症，其中7例患有低位直肠癌和肛门癌，伴有严重的肛门直肠CD病变。6例肛门直肠区域晚期癌患者中有5例接受了术前放化疗，所有7例肛门直肠癌患者均接受了腹会阴联合切除术。2例回直肠或回乙状结肠瘘癌患者接受了包括瘘管在内的小肠和大肠部分切除术。6例患者为黏液细胞型癌，2例为印戒细胞型癌，1例为低分化腺癌。3例在随访检查前死亡。
CD患者肠道癌的发病率有所增加。为CD患者建立监测计划很重要，尤其是那些合并严重肛门直肠CD病变的患者。
