Kekilli Murat, Dagli Ulku, Kalkan Ismail Hakki, Tunc Bilge, Disibeyaz Selcuk, Ulker Aysel, Sahin Burhan
Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Scand J Gastroenterol. 2010 Apr;45(4):434-9. doi: 10.3109/00365520903540830.
To determine the incidences of dysplasia, adenomatous polyp and colon cancer in patients with ulcerative colitis (UC) and to evaluate the risk factors.
We retrospectively reviewed the medical records of patients with UC admitted to the Turkiye Yuksek Ihtisas Hospital between 1994 and 2008 and who subsequently developed colorectal cancer (CRC).
Between 1994 and 2008, a total of 844 UC patients were followed in our clinic. A total of 275 patients entered our surveillance programme. The duration of UC was as follows: 10-15 years, n = 173 (62.9%); 15-20 years, n = 55 (20.0%); 20-25 years, n = 26 (9.5%), 25-30 years, n = 9 (3.3%); and > 30 years, n = 12 (4.4%). In terms of localization, 80 patients (29.1%) had distal disease, 107 (38.9%) had left-sided disease and 88 (32.0%) had extensive colitis. Adenomatous polyp was found in six patients (2.2%). Five cases (83.3% of the polyps) were in the diseased segment and one case (16.7%) was in the non-diseased segment. Endoscopy revealed dysplasia in 11 cases (4.0%). Of the 275 UC patients, CRC was diagnosed in only three (1.1%) during follow-up. Adenomatous polyp was not found in cases with colon cancer.
In our cases with UC, rates of dysplasia and CRC were much lower than in other reports. The difference in rates may be explained by racial factors, specific environmental factors, intensive control of disease activity through medical therapy and effective colonoscopic surveillance programmes.
确定溃疡性结肠炎（UC）患者发育异常、腺瘤性息肉和结肠癌的发病率，并评估风险因素。
我们回顾性分析了1994年至2008年间入住土耳其尤克谢克伊蒂萨斯医院且随后发生结直肠癌（CRC）的UC患者的病历。
1994年至2008年间，我们诊所共对844例UC患者进行了随访。共有275例患者进入我们的监测计划。UC的病程如下：10 - 15年，n = 173（62.9%）；15 - 20年，n = 55（20.0%）；20 - 25年，n = 26（9.5%），25 - 30年，n = 9（3.3%）；> 30年，n = 12（4.4%）。就病变部位而言，80例（29.1%）为远端疾病，107例（38.9%）为左侧疾病，88例（32.0%）为广泛性结肠炎。6例患者（2.2%）发现腺瘤性息肉。5例（息肉的83.3%）位于病变段，1例（16.7%）位于非病变段。内镜检查发现11例（4.0%）发育异常。在275例UC患者中，随访期间仅3例（1.1%）诊断为CRC。结肠癌患者未发现腺瘤性息肉。
在我们的UC病例中，发育异常和CRC的发生率远低于其他报告。发生率的差异可能由种族因素、特定环境因素、通过药物治疗对疾病活动的强化控制以及有效的结肠镜监测计划来解释。
